DEACONESS HOSPITAL INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
DEACONESS HOSPITAL INC (EIN 35-0593390)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-05-10
IRS object ID
201431309349300608
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-10T12:53:42-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN351178661EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BLUE & CO LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1ONE AMERICAN SQUARE 2200AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46282ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN350593390EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1DEACONESS HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlDEACNameControl
Phone8124503296Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 MARY STREETAddressLine1
CityEVANSVILLECity
StateINState
ZIP Code47747ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSHAWN MCCOYName
TitleCHIEF ADMINISTRATIVE OFFICERTitle
Phone8124503296Phone
Date Signed2014-05-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameAMBER KOCHER CPAName
PTINP01286298PTIN
Phone3176334705Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSHAWN W MCCOY CAONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1600 MARY STREETAddressLine1
CityEVANSVILLECity
StateINState
ZIP Code47747ZIPCode
FieldValueIRS element (for citing)
Gross Receipts749274534GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.DEACONESS.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1895YearFormation
State Legal DomicileINStateLegalDomicile
Activity Or Mission DescriptionPROVIDE QUALITY HEALTH CARE SERVICES WITH A COMPASSIONATE AND CARING SPIRIT CONTINUE TO SCH O TO PERSONS, FAMILIES AND COMMUNITIES OF THE TRI-STATE.ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees5493TotalNbrEmployees
Total Nbr Volunteers235TotalNbrVolunteers
Total Gross UBI11227601TotalGrossUBI
Net Unrelated Business Txbl Income-19012NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1888774ContributionsGrantsPriorYear
Contributions Grants Current Year1649475ContributionsGrantsCurrentYear
Program Service Revenue Prior Year515082254ProgramServiceRevenuePriorYear
Program Service Revenue CY531568224ProgramServiceRevenueCY
Investment Income Prior Year8461947InvestmentIncomePriorYear
Investment Income Current Year4987420InvestmentIncomeCurrentYear
Other Revenue Prior Year51646845OtherRevenuePriorYear
Other Revenue Current Year52034431OtherRevenueCurrentYear
Total Revenue Prior Year577079820TotalRevenuePriorYear
Total Revenue Current Year590239550TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year295491GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY578388GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year247753296SalariesEtcPriorYear
Salaries Etc Current Year255744305SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year364666TotalFundrsngExpCurrentYear
Other Expense Prior Year270678198OtherExpensePriorYear
Other Expenses Current Year268997419OtherExpensesCurrentYear
Total Expenses Prior Year518726985TotalExpensesPriorYear
Total Expenses Current Year525320112TotalExpensesCurrentYear
Revenues Less Expenses Prior Year58352835RevenuesLessExpensesPriorYear
Revenues Less Expenses CY64919438RevenuesLessExpensesCY
Total Assets BOY819821086TotalAssetsBOY
Total Assets EOY869894363TotalAssetsEOY
Total Liabilities BOY382563647TotalLiabilitiesBOY
Total Liabilities EOY349588545TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY437257439NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY520305818NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSEE SCHEDULE O.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense143852079Expense
Revenue316070548Revenue
DescriptionPATIENT SERVICE REVENUE. SEE SCHEDULE O.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense338408631Expense
Revenue205242013Revenue
DescriptionCHARITY CARE/SUBSIDIZED CARE. SEE SCHEDULE O.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense17170574Expense
Revenue10255663Revenue
DescriptionGRADUATE MEDICAL EDUCATION, MEDICAL EDUCATION AND COMMUNITY BENEFIT. SEE SCHEDULE O.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense578388Expense
Grants578388Grants
Revenue26019726Revenue
FieldValueIRS element (for citing)
Total Of Other Program Service Exp578388TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt578388TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev26019726TotalOfOtherProgramServiceRev
Total Program Service Expense500009672TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account1EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096410NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees5493NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Form1098 C Filed0Form1098CFiled
Excess Business Holdings0ExcessBusinessHoldings
Taxable Distributions0TaxableDistributions
Distribution To Donor0DistributionToDonor
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address1OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledINStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CHERYL A WATHENBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8124503296TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1600 MARY STREETAddressLine1
CityEVANSVILLECity
StateINState
ZIP Code47747ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (33 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
LINDA E WHITE
PRESIDENT/ CEO40.0030.00XX641386324241242168
JEROME A BENKERT JR
CHAIRMAN5.005.00X580000
STEVEN T TITZER CPA
VICE CHAIRMAN5.0010.00X600012000
JOHN ENGELBRECHT
TREASURER5.005.00X780000
BRUCE STALLINGS
SECRETARY5.005.00X760000
BRUCE ADYE MD
DIRECTOR7.005.00X1100000
STEVEN A CHURCH
DIRECTOR5.005.00X380000
REV DR JOSEPH FRACCARO
DIRECTOR5.005.00X500000
DAVID A KOEHLER JR MD
DIRECTOR25.0035.00X9801516793914420
WILLIAM PENLAND MD
DIRECTOR5.005.00X500000
ROBERT B WRIGHT
DIRECTOR5.005.00X740020000
DANIEL W WHITEHEAD MD
DIRECTOR5.005.00X2520000
MATHIAS KOLLECK II
DIRECTOR25.005.00X325208045041
DANIEL HERMANN
DIRECTOR5.005.00X000
ROBERT KELLER
DIRECTOR5.005.00X000
SHARON REED WALKER
DIRECTOR5.005.00X000
SHAWN W MCCOY
CHIEF ADMINISTRATIVE OFFIC50.0010.00X5007429000119505
CHERYL A WATHEN
CHIEF FINANCIAL OFFICER50.0010.00X282777171300107341
JAMES R PORTER MD
CHIEF MEDICAL OFFICER50.005.00X5262102800131061
CHERONA J HAJEWSKI
CHIEF NURSING OFFICER50.000.00X378529083585
BRUCE E EPMEIER
VICE PRESIDENT50.000.00X335237069530
LARRY F PILE
HR DIRECTOR50.005.00279611220511732X
LYNN C LINGAFELTER
DIRECTOR ER/SURGICAL50.000.00204897026093X
RICHARD B PERRY
CONTROLLER50.000.00208170030179X
JOHN L ZABROWSKI
CONTROLLER50.0010.00207787300040728X
JOYCE A THOMAS
PHARMACY DIRECTOR50.000.00173403049766X
REBECCA L MALOTTE
EXEC. DIRECTOR, CNO50.000.00177273054623X
VENKATESH R MADADI
ANESTHESIOLOGIST50.000.00680818056136X
NIRMAL JOSHI MD
ANESTHESIOLOGIST50.000.00722406060544X
RAJESH J PATEL MD
ANESTHESIOLOGIST50.000.00743257034595X
AYMAN ELFAR MD
ANESTHESIOLOGIST50.000.00593181051830X
LAWRENCE C KILINSKI JR MD
ANESTHESIOLOGIST50.000.00594465053659X
HARRY L SMITH JR
FORMER PRESIDENT TERM. JAN0.000.00392735043776X
FieldValueIRS element (for citing)
Total Reportable Comp From Org8150707TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs683685TotalReportableCompFrmRltdOrgs
Total Other Compensation1326312TotalOtherCompensation
Number Individuals GT100 K197NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
EVANSVILLE SURGERY CENTER
PO BOX 2185EVANSVILLEIN47728SURGICAL SERVICES28732379
WINK CONSTRUCTION INC
4007 E EICHEL AVEEVANSVILLEIN47716BUILDING CONTRACTOR5931732
EPIC SYSTEMS CORPORATION
PO BOX 88314MILWAUKEEWI53288SOFTWARE/ CONSULTING3425048
EVANSVILLE SURGERY ASSOCIATES
520 MARY STREETEVANSVILLEIN47710SURGICAL SERVICES2464881
KAHN DEES DONOVAN & KAHN LLP
501 MAIN STREETEVANSVILLEIN47735LAW SERVICES2434978
FieldValueIRS element (for citing)
Number Of Contractors GT100 K60NumberOfContractorsGT100K
Fundraising Events100941FundraisingEvents
Government Grants184708GovernmentGrants
All Other Contributions1363826AllOtherContributions
Noncash Contributions370399NoncashContributions
Total Contributions1649475TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT REVENUEDescription
Business Code900099BusinessCode
Total Revenue Column531568224TotalRevenueColumn
Related Or Exempt Function Income531568224RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue531568224TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column10164342TotalRevenueColumn
Exclusion$10,164,342ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column15009TotalRevenueColumn
Exclusion$15,009ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real7203557Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real2909670Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real4293887Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column4293887TotalRevenueColumn
Exclusion$4,293,887ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities150495594Securities
Other294016Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities149584881Securities
Other6396660Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities910713Securities
Other-6102644Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-5191931TotalRevenueColumn
Exclusion-$5,191,931ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events48700GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events100941CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses143773FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-95073TotalRevenueColumn
Exclusion-$95,073ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
INVESTMENT IN JOINT VENTURES9000992601972626019726
LABORATORY SALES6215001078158510781585
CMS MEANINGFUL USE9000993916943$3,916,943

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column7117363TotalRevenueColumn
Unrelated Business Revenue446016UnrelatedBusinessRevenue
Exclusion$6,671,347ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue47835617TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column590239550TotalRevenueColumn
Related Or Exempt Function Income557587950RelatedOrExemptFunctionIncome
Unrelated Business Revenue11227601UnrelatedBusinessRevenue
Exclusion$19,774,524ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total578388Total
Program Services578388ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total5407382Total
Management And General5407382ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total188093447Total
Program Services183152816ProgramServices
Management And General4694730ManagementAndGeneral
Fundraising245901Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total17286336Total
Program Services15764621ProgramServices
Management And General1521715ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total31592927Total
Program Services29862385ProgramServices
Management And General1730542ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total13364213Total
Program Services12671349ProgramServices
Management And General692864ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2329465Total
Program Services1550908ProgramServices
Management And General778557ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total94894Total
Management And General94894ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total32237Total
Management And General32237ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total410806Total
Management And General393302ManagementAndGeneral
Fundraising17504Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total56176905Total
Program Services54876547ProgramServices
Management And General1274012ManagementAndGeneral
Fundraising26346Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total1188805Total
Program Services117553ProgramServices
Management And General1071252ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total11119266Total
Program Services10008736ProgramServices
Management And General1062501ManagementAndGeneral
Fundraising48029Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total8379770Total
Program Services7328652ProgramServices
Management And General1051118ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total16534132Total
Program Services15177862ProgramServices
Management And General1356270ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total960228Total
Program Services809362ProgramServices
Management And General150866ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total841465Total
Program Services629264ProgramServices
Management And General211096ManagementAndGeneral
Fundraising1105Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total8603870Total
Program Services8603870ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total39181434Total
Program Services36713406ProgramServices
Management And General2468010ManagementAndGeneral
Fundraising18Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total1768049Total
Program Services1760454ProgramServices
Management And General7595ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL/SURGICAL SUPPLI858677598581845649303
MEDICAID ASSESSMENT FEE1477551014775510
EQUIP RENTAL/MAINTENANC1274208312463055279028
AGENCY COLLECTION FEES62621866262186

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1728555Total
Program Services1084292ProgramServices
Management And General618500ManagementAndGeneral
Fundraising25763Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total525320112Total
Program Services500009672ProgramServices
Management And General24945774ManagementAndGeneral
Fundraising364666Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY54671462BOY
EOY43965528EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY88496093BOY
EOY79773146EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY980947BOY
EOY1051175EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5592070BOY
EOY5518992EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4566672BOY
EOY5393760EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis740768222LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec428226748LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY328708749BOY
EOY312541474EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY270497387BOY
EOY354838689EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY33696074BOY
EOY34131516EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY15522009BOY
EOY15522009EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY17089623BOY
EOY17158074EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY819821086BOY
EOY869894363EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY59087211BOY
EOY60092128EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY244662BOY
EOY251958EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY205620955BOY
EOY206158405EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY117610819BOY
EOY83086054EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY382563647BOY
EOY349588545EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY432200551BOY
EOY514674469EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3293842BOY
EOY3782581EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1763046BOY
EOY1848768EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY437257439BOY
EOY520305818EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY819821086BOY
EOY869894363EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses64919438ReconcilationRevenueExpenses
Reconcilation Other Changes18128941ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$32,237OtherActivitiesAmount
Total Lobbying Expenditures IIB32237TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationLOBBYING EXPENDITURES CONSISTED OF A PORTION OF MEMBERSHIP DUES TO PROFESSIONAL ORGANIZATIONS IN WHICH DEACONESS HOSPITAL AND ITS EMPLOYEES ARE MEMBERS. THE LOBBYING PORTION OF THE DUES IS NOTED ON THE MEMBERSHIP APPLICATION OR BILLING STATEMENT.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance5544426BeginningOfYearBalance
Contributions1890Contributions
Investment Earnings Or Losses611864InvestmentEarningsOrLosses
Other Expenditures38483OtherExpenditures
Administrative Expenses289AdministrativeExpenses
End Of Year Balance6119408EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance8353428BeginningOfYearBalance
Contributions6871Contributions
Investment Earnings Or Losses541295InvestmentEarningsOrLosses
Other Expenditures3357168OtherExpenditures
End Of Year Balance5544426EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance8130489BeginningOfYearBalance
Contributions1293267Contributions
Investment Earnings Or Losses294514InvestmentEarningsOrLosses
Grants Or Scholarships7052GrantsOrScholarships
Other Expenditures1048880OtherExpenditures
Administrative Expenses308910AdministrativeExpenses
End Of Year Balance8353428EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance7433786BeginningOfYearBalance
Contributions1683536Contributions
Investment Earnings Or Losses281910InvestmentEarningsOrLosses
Grants Or Scholarships192998GrantsOrScholarships
Other Expenditures790792OtherExpenditures
Administrative Expenses284953AdministrativeExpenses
End Of Year Balance8130489EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance7797671BeginningOfYearBalance
Contributions931781Contributions
Investment Earnings Or Losses337059InvestmentEarningsOrLosses
Grants Or Scholarships329950GrantsOrScholarships
Other Expenditures1014396OtherExpenditures
Administrative Expenses288379AdministrativeExpenses
End Of Year Balance7433786EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.86000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.14000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis495397InvestmentCostOrOtherBasis
Other Cost Or Other Basis9854366OtherCostOrOtherBasis
Book Value10349763BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis48151381InvestmentCostOrOtherBasis
Other Cost Or Other Basis428755603OtherCostOrOtherBasis
Depreciation240194336Depreciation
Book Value236712648BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis248898529OtherCostOrOtherBasis
Depreciation188032412Depreciation
Book Value60866117BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4612946OtherCostOrOtherBasis
Book Value4612946BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings312541474TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
ACCRUED RETIREMENT BENEFITS$61,125,664
TAXABLE BOND- SERIES 2012C$8,200,000
ESTIMATED THIRD PARTY SETTLEMENTS$6,224,177
TAXABLE BOND-SERIES 2012A$4,985,000
CAPITAL LEASE OBLIGATIONS$1,814,482
RELATED ORGANIZATION PAYABLES$736,731
FieldValueIRS element (for citing)
Total Of Amounts83086054TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:TEMPORARILY RESTRICTED NET ASSETS INCLUDE THOSE ASSETS WHOSE USE BY THE SYSTEM HAS BEEN TEMPORARILY LIMITED PRIMARY FOR CAPITAL PROJECTS OR A SPECIFIED TIME PERIOD OR PURPOSE. TEMPORARILY RESTRICTED NET ASSETS HAVE BEEN RESTRICTED FOR USE IN PATIENT MEDICAL CARE, EDUCATION AND SCHOLARSHIPS, CAPITAL PROJECTS, AND OTHER SYSTEM SUPPORT. PERMANENTLY RESTRICTED NET ASSETS ARE CONTRIBUTED WITH DONOR RESTRICTIONS REQUIRING THEY BE HELD IN PERPETUITY WITH INCOME USED TO SUPPORT THE SYSTEM'S ACTIVITIES. PERMANENTLY RESTRICTED NET ASSETS INCLUDE BENEFICIAL INTEREST IN TRUSTS AND OTHER PERMANENT RESTRICTIONS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE SYSTEM AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2013 AND 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY TAKING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGESS.
PART VII AND IX: SECTIONS ARE NOT REQUIRED AS THE TOTALS FOR EACH LINE ARE LESS THAN 5% OF THE TOTAL ASSETS LISTED ON FORM 990, PART X, LINE 16.
PART XI AND XII: SECTIONS ARE NOT REQUIRED AS THE ORGANIZATION IS PART OF A CONSOLIDATED FINANCIAL STATEMENT. THE CONSOLIDATED FINANCIAL STATEMENT IS AUDITED BY AN INDEPENDENT ACCOUNTING FIRM AND IS PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1DH CLASSICNameOfEvent1
Gross Receipts Event1124716GrossReceiptsEvent1
Charitable Contributions Event1100016CharitableContributionsEvent1
Gross Revenue Event124700GrossRevenueEvent1
Non Cash Prizes Event139410NonCashPrizesEvent1
Food And Beverage Event118500FoodAndBeverageEvent1
Entertainment Event115187EntertainmentEvent1
Other Direct Expenses Event13637OtherDirectExpensesEvent1
Name Of Event2DH PARTY OF THE YEARNameOfEvent2
Gross Receipts Event224925GrossReceiptsEvent2
Charitable Contributions Event2925CharitableContributionsEvent2
Gross Revenue Event224000GrossRevenueEvent2
Food And Beverage Event248029FoodAndBeverageEvent2
Entertainment Event2895EntertainmentEvent2
Other Direct Expenses Event218115OtherDirectExpensesEvent2
Total Number Of Other Events0TotalNumberOfOtherEvents
Gross Receipts Total149641GrossReceiptsTotal
Charitable Contributions Total100941CharitableContributionsTotal
Gross Revenue Total Events48700GrossRevenueTotalEvents
Non Cash Prizes Total Events39410NonCashPrizesTotalEvents
Food And Beverage Total Events66529FoodAndBeverageTotalEvents
Entertainment Total Events16082EntertainmentTotalEvents
Other Direct Expenses Total Events21752OtherDirectExpensesTotalEvents
Direct Expense Summary Events143773DirectExpenseSummaryEvents
Net Income Summary-95073NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage300.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense22872446TotalCommunityBenefitExpense
Net Community Benefit Expense22872446NetCommunityBenefitExpense
Percent Of Total Expense0.03960PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense73681506TotalCommunityBenefitExpense
Direct Offsetting Revenue53624066DirectOffsettingRevenue
Net Community Benefit Expense20057440NetCommunityBenefitExpense
Percent Of Total Expense0.03470PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense96553952TotalCommunityBenefitExpense
Direct Offsetting Revenue53624066DirectOffsettingRevenue
Net Community Benefit Expense42929886NetCommunityBenefitExpense
Percent Of Total Expense0.07430PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense732049TotalCommunityBenefitExpense
Direct Offsetting Revenue36211DirectOffsettingRevenue
Net Community Benefit Expense695838NetCommunityBenefitExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense4403251TotalCommunityBenefitExpense
Direct Offsetting Revenue1658288DirectOffsettingRevenue
Net Community Benefit Expense2744963NetCommunityBenefitExpense
Percent Of Total Expense0.00480PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense8961794TotalCommunityBenefitExpense
Direct Offsetting Revenue6565848DirectOffsettingRevenue
Net Community Benefit Expense2395946NetCommunityBenefitExpense
Percent Of Total Expense0.00410PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense1146998TotalCommunityBenefitExpense
Direct Offsetting Revenue28933DirectOffsettingRevenue
Net Community Benefit Expense1118065NetCommunityBenefitExpense
Percent Of Total Expense0.00190PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense15244092TotalCommunityBenefitExpense
Direct Offsetting Revenue8289280DirectOffsettingRevenue
Net Community Benefit Expense6954812NetCommunityBenefitExpense
Percent Of Total Expense0.01200PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense111798044TotalCommunityBenefitExpense
Direct Offsetting Revenue61913346DirectOffsettingRevenue
Net Community Benefit Expense49884698NetCommunityBenefitExpense
Percent Of Total Expense0.08630PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense1555TotalCommunityBuildingExpense
Net Community Building Expense1555NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense10946TotalCommunityBuildingExpense
Direct Offsetting Revenue660DirectOffsettingRevenue
Net Community Building Expense10286NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Total Community Building Expense1801TotalCommunityBuildingExpense
Net Community Building Expense1801NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense4000TotalCommunityBuildingExpense
Net Community Building Expense4000NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense8207TotalCommunityBuildingExpense
Net Community Building Expense8207NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense935TotalCommunityBuildingExpense
Net Community Building Expense935NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense64434TotalCommunityBuildingExpense
Direct Offsetting Revenue16350DirectOffsettingRevenue
Net Community Building Expense48084NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense91878TotalCommunityBuildingExpense
Direct Offsetting Revenue17010DirectOffsettingRevenue
Net Community Building Expense74868NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$40,019,702BadDebtExpenseAmount
Amount Reimbursed By Medicare131537693AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare151926989CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-20389296MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities3NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (3 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeWebsite AddressWebsiteAddressLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalTeaching HospitalTeachingHospitalEr24 HoursEr24Hours
DEACONESS HOSPITAL INC
1600 MARY STREETEVANSVILLEIN47747WWW.DEACONESS.COMXXXX
DEACONESS GATEWAY HOSPITAL
24011 GATEWAY BLVDNEWBURGHIN47630WWW.DEACONESS.COMXXXX
DEACONESS CROSS POINTE
37200 E INDIANA STREETEVANSVILLEIN47715WWW.DEACONESS.COMX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (3 entries)

Hospital Facility NumberHospitalFacilityNumberCHNA ConductedCHNAConductedCommunity DefinitionCommunityDefinitionCommunity DemographicsCommunityDemographicsExisting ResourcesExistingResourcesHow Data ObtainedHowDataObtainedCommunity Health NeedsCommunityHealthNeedsOther Health IssuesOtherHealthIssuesIdentifying ProcessIdentifyingProcessConsulting ProcessConsultingProcessInformation GapsInformationGapsNeeds Assessment ConductedNeedsAssessmentConductedTake Into AccountTakeIntoAccountOther FacilitiesOtherFacilitiesCHNA Widely AvailableCHNAWidelyAvailableOwn WebsiteOwnWebsiteOn RequestOnRequestAdopt Implement StrategyAdoptImplementStrategyExecute Implement StrategyExecuteImplementStrategyDevelop Community PlanDevelopCommunityPlanParticipate Community PlanParticipateCommunityPlanInclude Operational PlansIncludeOperationalPlansAdopt BudgetAdoptBudgetPrioritize Health NeedsPrioritizeHealthNeedsPrioritize ServicesPrioritizeServicesAll Needs AddressedAllNeedsAddressedOrganization Incur Excise TaxOrganizationIncurExciseTaxEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelAsset LevelAssetLevelMedical IndigencyMedicalIndigencyUninsured DiscountUninsuredDiscountMedicaid MedicareMedicaidMedicareExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresAttached To InvoicesAttachedToInvoicesAvailable On RequestAvailableOnRequestOther PublicityOtherPublicityActions On NonpaymentActionsOnNonpaymentCollection ActivitiesCollectionActivitiesNotify Before DischargeNotifyBeforeDischargeNotified All PatientsNotifiedAllPatientsDocumented DeterminationDocumentedDeterminationNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
DEACONESS HOSPITAL INC
11XXXXXXXXX12111XXXXXXXXXX1011300.0000000000001300.0000000000001XXXXX11XXX10XXX1X00
DEACONESS GATEWAY HOSPITAL
21XXXXXXXXX12111XXXXXXXXXX1011300.0000000000001300.0000000000001XXXXX11XXX10XXX1X00
DEACONESS CROSS POINTE
31XXXXXXXXX12111XXXXXXXXXX1011300.0000000000001300.0000000000001XXXXX11XXX10XXX1X00

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities45NumberOfOtherFacilities

Other Facilities OtherFacilities (45 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
DEACONESS PROCEDURE CENTER
421 CHESTNUT STREETEVANSVILLEIN47713OUTPATIENT SERVICES
DEACONESS HOSPITAL PHYSICAL MEDICINE
520 MARY STREET SUITE 280EVANSVILLEIN47747OUTPATIENT SERVICES
DEACONESS COMPREHENSIVE PAIN CTR & PROG
4600 W LLOYD EXPRESSWAYEVANSVILLEIN47712OUTPATIENT SERVICES
DEACONESS CHEMOTHERAPY INFUSION CTR
4055 GATEWAY BLVD SUITE 1200NEWBURGHIN47630OUTPATIENT SERVICES
DEACONESS HOSPITAL INFUSION SVCS
421 CHESTNUT STREETEVANSVILLEIN47713OUTPATIENT SERVICES
DEACONESS HOSPITAL PHYSICAL MEDICINE
10455 ORTHOPAEDIC DRIVENEWBURGHIN47630OUTPATIENT SERVICES
DEACONESS COMPREHENSIVE PAIN CTR-GATEWAY
4099 GATEWAY BLVDNEWBURGHIN47630OUTPATIENT SERVICES
DEACONESS CRITICAL CARE GROUP
519 HARRIET STREETEVANSVILLEIN47747OUTPATIENT PHYSICIAN CLINIC
DEACONESS HOSPITAL BREAST CENTER
520 MARY STREET SUITE 140EVANSVILLEIN47710DIAGNOSTIC CENTER
DEACONESS REGIONAL LABORATORY
421 CHESTNUT STREETEVANSVILLEIN47713DIAGNOSTIC CENTER
DEACONESS HOME CARE
701 GARFIELD STREETEVANSVILLEIN47747HOME HEALTH AGENCY
CHANCELLOR CENTER FOR ONCOLOGY
4055 GATEWAY BLVDNEWBURGHIN47630OUTPATIENT SERVICES
DEACONESS SLEEP LAB
350 W COLUMBIA STREET SUITE 210EVANSVILLEIN47710OUTPATIENT SERVICES
DEACONESS SLEEP LAB
350 W COLUMBIA STREET SUITE LL-10EVANSVILLEIN47710DIAGNOSTIC CENTER
DEACONESS OHIO VALLEY HOSPICE
701 GARFIELD STREETEVANSVILLEIN47747HOSPICE
DEACONESS REGIONAL LABORATORY
4133 GATEWAY BLVD SUITE 110NEWBURGHIN47630DIAGNOSTIC CENTER
THE FAMILY PRACTICE CENTER
515 READ STREETEVANSVILLEIN47710OUTPATIENT PHYSICIAN CLINIC
DEACONESS WOUND CARE CENTER
611 HARRIET STREET SUITE 501EVANSVILLEIN47710OUTPATIENT SERVICES
DEACONESS HOSPITAL MAMMOGRAPHY & IMAGING
421 CHESTNUT STREETEVANSVILLEIN47713DIAGNOSTIC CENTER
DEACONESS CLINIC GATEWAY REG LAB
4233 GATEWAY BLVDNEWBURGHIN47630DIAGNOSTIC CENTER
DEACONESS ANTICOAGULATION CLINIC
4107 GATEWAY BLVDNEWBURGHIN47630OUTPATIENT SERVICES
DEACONESS CLINIC WEST REG LAB RADIOLOGY
545 S BOEHNE CAMP ROADEVANSVILLEIN47712OUTPATIENT PHYSICIAN CLINIC
MIDWEST RADIOLOGIC IMAGING
10455 ORTHOPAEDIC DRIVENEWBURGHIN47630DIAGNOSTIC CENTER
MIDWEST RADIOLOGICAL IMAGING
4087 GATEWAY BLVDNEWBURGHIN47630DIAGNOSTIC CENTER
DEACONESS REGIONAL LABORATORY
611 HARRIET STREET SUITE 102EVANSVILLEIN47710DIAGNOSTIC CENTER
DEACONESS RILEY CHILDREN'S SPECIALTY CTR
4133 GATEWAY BLVDNEWBURGHIN47630OUTPATIENT PHYSICIAN CLINIC
DEACONESS RILEY SPECIALITY CTR OP
4121 GATEWAY BLVDNEWBURGHIN47630OUTPATIENT PHYSICIAN CLINIC
DOCTOR'S PLAZA X-RAY
611 HARRIET STREETEVANSVILLEIN47710DIAGNOSTIC CENTER
DEACONESS PRIMARY CARE FOR SENIORS
4498 FIRST AVENUEEVANSVILLEIN47710OUTPATIENT PHYSICIAN CLINIC
DEACONESS REGIONAL LABORATORY
4494 N FIRST AVENUEEVANSVILLEIN47710DIAGNOSTIC CENTER
DEACONESS CLINIC PRINCETON RADIOLOGY SRV
685 VAIL STREETPRINCETONIN47670OUTPATIENT PHYSICIAN CLINIC
DEACONESS PRIMARY CARE FOR SENIORS
1750 OAK HILL ROADEVANSVILLEIN47710OUTPATIENT PHYSICIAN CLINIC
DEACONESS PRE-ADMISSION TESTING
520 MARY STREET SUITE 330EVANSVILLEIN47747DIAGNOSTIC CENTER
MT VERNON MEDICAL CENTER LAB & RADIOLOGY
1900 W FOURTH STREETMT VERNONIN47620DIAGNOSTIC CENTER
DEACONESS FAMILY MEDICINE
611 HARRIET STREET SUITE 504EVANSVILLEIN47710OUTPATIENT PHYSICIAN CLINIC
DEACONESS DIABETES CENTER - EDUCATION
421 CHESTNUT STREETEVANSVILLEIN47713OUTPATIENT SERVICES
DEACONESS GATEWAY GASTROENTEROLOGY
4133 GATEWAY BLVDNEWBURGHIN47630OUTPATIENT PHYSICIAN CLINIC
DEACONESS WEIGHT LOSS SOLUTIONS
310 W IOWA STREETEVANSVILLEIN47710OUTPATIENT PHYSICIAN CLINIC
DEACONESS REGIONAL LABORATORY
1204 W WILLIAMS STREETOAKLAND CITYIN47660DIAGNOSTIC CENTER
DEACONESS CROSS POINTE-OWENSBORO
920 FREDERICA STREET SUITE 1003OWENSBOROKY42301OUTPATIENT PHYSICIAN CLINIC
DEACONESS CROSS POINTE-HENDERSON
209 N ELM STREETHENDERSONKY42420OUTPATIENT PHYSICIAN CLINIC
DEACONESS CROSS POINTE OUTPATIENT CLINIC
445 CROSS POINTE BLVDEVANSVILLEIN47715OUTPATIENT PHYSICIAN CLINIC
DEACONESS CROSS POINTE
7200 E INDIANAEVANSVILLEIN47715OUTPATIENT PHYSICIAN CLINIC
DEACONESS RADIOLOGY LABORATORY- MT PLEA
8600 NORTH KENTUCKY AVENUEEVANSVILLEIN47725DIAGNOSTIC CENTER
DEACONESS RADIOLOGY SERVICES- MT PLEASA
8600 NORTH KENTUCKY AVENUEEVANSVILLEIN47725DIAGNOSTIC CENTER

Form990 Schedule H Part VI Form990ScheduleHPartVI (31 entries)

ExplanationExplanationIdentifierIdentifier
PART I, LINE 6A: DEACONESS HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT. THE REPORT IS MADE AVAILABLE IN THE FOLLOWING WAYS:1. MAILED TO ALL THE MAJOR EMPLOYERS IN THE TRI-STATE AREA.2. AN ADVERTISEMENT IS PLACED IN THE SUNDAY PAPER OF THE EVANSVILLE COURIER AND PRESS.3. IS MADE AVAILABLE ON THE DEACONESS WEBSITE AT HTTP://WWW.DEACONESS.COM/CAREERS/FOR-OUR-EMPLOYEES/ OUR-COMMUNITY/COMMUNITY-BENEFIT.ASPX
PART I, LINE 7: A COST TO CHARGE RATIO WAS USED FOR MOST OF THE CALCULATIONS FOR THE TABLE. IRS INSTRUCTION'S WORKSHEET 2 WAS USED FOR THIS CALCULATION. WE DID NOT USE THE COST TO CHARGE RATIO FOR LINE 7G AS IT WAS NOT RELEVANT TO THESE SERVICES. THE ACTUAL COST FROM OUR COSTING SYSTEM WAS USED WHEN AVAILABLE. THE COST TO CHARGE RATIO FOR EACH SERVICE TYPE WAS USED TO ESTIMATE COST WHEN NOT AVAILABLE FROM OUR INTERNAL COSTING SYSTEM.
PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES ATTRIBUTED TO PHYSICIAN CLINICS HAVE A COST OF $455,161. THESE CLINICS ARE OPERATED AS A BENEFIT TO THE COMMUNITY.
PART I, L7 COL(F): THE BAD DEBT EXPENSE IS NOT INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) DUE TO EARLY ADOPTION OF ACCOUNTING STANDARDS UPDATE (ASU) 2011-07, HEALTHCARE ENTITIES (TOPIC 954).
PART II: COMMUNITY BUILDING ACTIVITIES:DURING FISCAL YEAR 2014, DEACONESS PROVIDED FINANCIAL SUPPORT TO MORE THAN 100 NON-PROFIT ORGANIZATIONS LOCATED IN OUR THREE-STATE SERVICE AREA. THIS INCLUDES SPONSORSHIP OF WALKS AND RUNS TO RAISE AWARENESS FOR DISEASES AND HEALTH CONDITIONS, DONATIONS TO AREA FOOD PANTRIES, SIGNIFICANT PARTNERSHIPS WITH EVENTS THAT FUND RESEARCH FOR BREAST CANCER AND TYPE 1 DIABETES, AND FUNDING FOR SOCIAL WORKERS SO THEY CAN BE IN THE MIDDLE AND HIGH SCHOOLS WHERE THEIR SERVICES ARE DESPERATELY NEEDED. THE HOSPITAL GAVE EACH TEACHER IN THE DESIGNATED "COMMUNITY BENEFIT SCHOOLS" $100 TO BUSY SUPPLIES FOR THEIR CLASSROOM, TOTALING OF $23,236. THE HOSPITAL ALSO SENT $100 TO EVERY "AFTER PROM" EVENT IN THE REGION TO PROVIDE TEENAGERS WITH A SAFE PLACE TO CELEBRATE FREE FROM DRUGS, ALCOHOL, AND RISKY BEHAVIOR, TOTALING $2,100. DEACONESS PROVIDED FREE AND REDUCED CARE WITHIN OUR HOSPITAL BUILDINGS. THROUGH OUR MEDICATION ASSISTANCE PROGRAM, OUR FAMILY PRACTICE RESIDENCY CLINIC, AND COMMUNITY HEALTH SCREENINGS, AREA RESIDENTS CAN ACCESS THE HIGH QUALITY HEALTHCARE THEY NEED IN CONVENIENT LOCATIONS AND AT A PRICE THEY CAN AFFORD. DEACONESS PROMOTES HEALTHY LIVING IN THE COMMUNITY THROUGH SEVERAL INITIATIVES INCLUDING:1. HEALTHIER U WORKS: ORGANIZED, OUTDOOR COMMUNITY WALK EVERY MORNING FROM APRIL TO OCTOBER2. WISE CHOICE: VENDORS AT THE ANNUAL FALL FESTIVAL SUBMIT RECIPES TO OUR DIETICIANS. IF THEY MEET CERTAIN NUTRITIONAL REQUIREMENTS, THE VENDOR'S BOOTH GETS A GREEN SIGN TO HANG THAT INDICATES THE SERVE HEALTHY FOOD OPTIONS AT THEIR BOOTH.3. MEN'S HEALTH SERIES: ONCE A MONTH FROM MARCH THROUGH NOVEMBER, MEN IN THE COMMUNITY ARE INVITED TO COME TO THE HOSPITAL, EAT DINNER, AND HEAR A PRESENTATION SPECIFICALLY GEARED TOWARD IMPROVING MEN'S HEALTH.4. COMMUNITY SCREENINGS: EACH, WEEK, REDUCED COST HEALTH SCREENINGS ARE OFFERED AT A DEACONESS CLINIC LOCATION. THE LOCATION ROTATES BETWEEN MULTIPLE STATES AND COUNTIES. 5. MENTAL HEALTH FIRST-AID COURSES: AN EDUCATION PROGRAM THAT HELPS THE PUBLIC IDENTIFIES, UNDERSTAND, AND RESPOND TO SIGNS OF MENTAL ILLNESSES AND SUBSTANCE ABUSE DISORDERS.6. TRAUMA EDUCATION: DEACONESS TRAUMA SERVICES DEVOTES TIME AND RESOURCES TO EDUCATING EMS PERSONNEL AND OTHER FIRST RESPONDERS IN THE REGION. 7. HEALTH SCIENCE INSTITUTE: A HANDS-ON SUMMER PROGRAM FOR HIGH SCHOOL STUDENTS INTERESTED IN THE MEDICAL PROFESSION. 8. SUICIDE PREVENTION: MEMBERS OF OUR MENTAL HEALTH HOSPITAL TRAVEL AROUND THE REGION TO PROVIDE SUICIDE PREVENTION TRAINING TO SCHOOLS, CHURCHES, NON-PROFIT GROUPS, ETC.
PART III, LINE 4: SECTION A. FOOTNOTE TO ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE: (BELOW IS THE PORTION OF THE AUDITED FINANCIAL STATEMENT FOOTNOTE "PATIENT ACCOUNTS RECEIVABLE, ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS AND NET PATIENT SERVICE REVENUE" RELATED TO BAD DEBTS.)PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON THE SYSTEM'S EVALUATION OF ITS MAJOR PAYOR SOURCES OF REVENUE, THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO ITS SERVICE AREA AND THE HEALTHCARE INDUSTRY. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PAYMENTS THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.
PART III, LINE 8: THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE REVENUE AND ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, LINE 8: THE MEDICARE TOTAL REVENUE AND ALLOWABLE COSTS WERE ESTIMATED BASED UPON THE 2013 MEDICARE COST REPORT. THE MEDICARE SHORTFALL FOR DEACONESS HOSPITAL IS TREATED AS COMMUNITY BENEFIT DUE TO THE HOSPITAL PROVIDING CARE TO MEDICARE PATIENTS AT LESS THAN THE ALLOWABLE MEDICARE COSTS.
PART III, LINE 9B: DEACONESS HOSPITAL MAKES A DISTINCTION BETWEEN CHARITY AND BAD DEBT. IN DETERMINING AN INDIVIDUAL OR FAMILY'S ABILITY TO PAY, DEACONESS HOSPITAL EVALUATES WHETHER OR NOT THE RESPONSIBLE PARTY HAS SUFFICIENT RESOURCES FOR PAYMENT. IF AN INDIVIDUAL IS DETERMINED TO NOT HAVE SUFFICIENT RESOURCES TO PAY, THEY WILL BE CONSIDERED ELIGIBLE FOR CHARITY CARE AND WILL NOT BE PROCESSED THROUGH EITHER INTERNAL OR EXTERNAL COLLECTIONS. ACCOUNTS OF CHARITY CARE PATIENTS WHO ARE UNABLE TO PAY DO NOT RESULT IN BAD DEBT AND ARE NOT COLLECTED UPON.
PART V, SECTION B, LINE 3: DESCRIPTION OF COMMUNITY INPUT:IN 2011, DEACONESS HEALTH SYSTEM JOINED FOUR OTHER LOCAL HEALTH-RELATED ORGANIZATIONS, ECHO COMMUNITY HEALTH CARE, ST. MARY'S MEDICAL CENTER, UNITED WAY, AND WELBORN BAPTIST FOUNDATION, TO PLAN FOR AND ADMINISTER A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). MEMBERS OF THE DEACONESS COMMUNITY BENEFIT TEAM MET REGULARLY WITH OTHER MEMBERS OF THE COLLABORATIVE TO CREATE A STRATEGY AND TACTICS THAT ADDRESS OUR FOUR IDENTIFIED COMMUNITY HEALTH NEEDS. WE ALSO PARTICIPATED IN FOCUS GROUP SESSIONS WITH 51 BUSINESS, COMMUNITY, AND SOCIAL SERVICE LEADERS AND STRATEGY SESSIONS WITH 42 PROVIDERS AND AGENCIES TO DEVELOP A PLAN THAT WOULD CAUSE POSITIVE CHANGE IN THE OVERALL HEALTH OF OUR POPULATION. ADDITIONALLY, EACH PARTNER CREATED AN ORGANIZATION SPECIFIC PLAN TO ADDRESS THE SAME ISSUES. THE PLANS WERE TRANSCRIBED, PRESENTED AT A PRESS CONFERENCE, AND POSTED ON THE WEBSITE OF EACH PARTNER'S ORGANIZATION.DEACONESS HOSPITAL, INC.
PART V, SECTION B, LINE 3: DESCRIPTION OF COMMUNITY INPUT:IN 2011, DEACONESS HEALTH SYSTEM JOINED FOUR OTHER LOCAL HEALTH-RELATED ORGANIZATIONS, ECHO COMMUNITY HEALTH CARE, ST. MARY'S MEDICAL CENTER, UNITED WAY, AND WELBORN BAPTIST FOUNDATION, TO PLAN FOR AND ADMINISTER A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). MEMBERS OF THE DEACONESS COMMUNITY BENEFIT TEAM MET REGULARLY WITH OTHER MEMBERS OF THE COLLABORATIVE TO CREATE A STRATEGY AND TACTICS THAT ADDRESS OUR FOUR IDENTIFIED COMMUNITY HEALTH NEEDS. WE ALSO PARTICIPATED IN FOCUS GROUP SESSIONS WITH 51 BUSINESS, COMMUNITY, AND SOCIAL SERVICE LEADERS AND STRATEGY SESSIONS WITH 42 PROVIDERS AND AGENCIES TO DEVELOP A PLAN THAT WOULD CAUSE POSITIVE CHANGE IN THE OVERALL HEALTH OF OUR POPULATION. ADDITIONALLY, EACH PARTNER CREATED AN ORGANIZATION SPECIFIC PLAN TO ADDRESS THE SAME ISSUES. THE PLANS WERE TRANSCRIBED, PRESENTED AT A PRESS CONFERENCE, AND POSTED ON THE WEBSITE OF EACH PARTNER'S ORGANIZATION.DEACONESS GATEWAY HOSPITAL
PART V, SECTION B, LINE 3: DESCRIPTION OF COMMUNITY INPUT:IN 2011, DEACONESS HEALTH SYSTEM JOINED FOUR OTHER LOCAL HEALTH-RELATED ORGANIZATIONS, ECHO COMMUNITY HEALTH CARE, ST. MARY'S MEDICAL CENTER, UNITED WAY, AND WELBORN BAPTIST FOUNDATION, TO PLAN FOR AND ADMINISTER A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). MEMBERS OF THE DEACONESS COMMUNITY BENEFIT TEAM MET REGULARLY WITH OTHER MEMBERS OF THE COLLABORATIVE TO CREATE A STRATEGY AND TACTICS THAT ADDRESS OUR FOUR IDENTIFIED COMMUNITY HEALTH NEEDS. WE ALSO PARTICIPATED IN FOCUS GROUP SESSIONS WITH 51 BUSINESS, COMMUNITY, AND SOCIAL SERVICE LEADERS AND STRATEGY SESSIONS WITH 42 PROVIDERS AND AGENCIES TO DEVELOP A PLAN THAT WOULD CAUSE POSITIVE CHANGE IN THE OVERALL HEALTH OF OUR POPULATION. ADDITIONALLY, EACH PARTNER CREATED AN ORGANIZATION SPECIFIC PLAN TO ADDRESS THE SAME ISSUES. THE PLANS WERE TRANSCRIBED, PRESENTED AT A PRESS CONFERENCE, AND POSTED ON THE WEBSITE OF EACH PARTNER'S ORGANIZATION.DEACONESS CROSS POINTE
PART V, SECTION B, LINE 4: OTHER HOSPITAL FACILITIES CHNA WAS CONDUCTED WITH:DEACONESS GATEWAY HOSPITALDEACONESS CROSS POINTEST. MARY'S MEDICAL CENTERDEACONESS HOSPITAL, INC.
PART V, SECTION B, LINE 4: OTHER HOSPITAL FACILITIES CHNA WAS CONDUCTED WITH:DEACONESS HOSPITAL, INC.DEACONESS CROSS POINTEST. MARY'S MEDICAL CENTERDEACONESS GATEWAY HOSPITAL
PART V, SECTION B, LINE 4: OTHER HOSPITAL FACILITIES CHNA WAS CONDUCTED WITH:DEACONESS HOSPITAL, INC.DEACONESS GATEWAY HOSPITALST. MARY'S MEDICAL CENTERDEACONESS CROSS POINTE
PART V, SECTION B, LINE 5C: CHNA IS MADE WIDELY AVAILABLE ON THE HOSPITAL'S WEBSITE: THE HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT IS LOCATED AT HTTP://WWW.DEACONESS.COM/CHNA.DEACONESS HOSPITAL, INC.
PART V, SECTION B, LINE 5C: CHNA IS MADE WIDELY AVAILABLE ON THE HOSPITAL'S WEBSITE: THE HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT IS LOCATED AT HTTP://WWW.DEACONESS.COM/CHNA.DEACONESS GATEWAY HOSPITAL
PART V, SECTION B, LINE 5C: CHNA IS MADE WIDELY AVAILABLE ON THE HOSPITAL'S WEBSITE: THE HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT IS LOCATED AT HTTP://WWW.DEACONESS.COM/CHNA.DEACONESS CROSS POINTE
PART V, SECTION B, LINE 6I: METHOD FOR ADDRESSING NEEDS IDENTIFIED IN CHNA:6A: IN 2011, DEACONESS HEALTH SYSTEM JOINED FOUR OTHER LOCAL HEALTH-RELATED ORGANIZATIONS, ECHO COMMUNITY HEALTH CARE, ST. MARY'S MEDICAL CENTER, UNITED WAY, AND WELBORN BAPTIST FOUNDATION, TO PLAN FOR AND ADMINISTER A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). REVIEW OF THE ASSESSMENT DATA LED THE TEAM TO IDENTIFY FOUR MAIN ISSUES AT THE CORE OF POOR COMMUNITY HEALTH: TOBACCO USE, OBESITY, SUBSTANCE ABUSE, AND MENTAL HEALTH. THE COLLABORATIVE CREATED A GROUP PLAN OF ACTION TO ADDRESS THE FOUR IDENTIFIED COMMUNITY HEALTH ISSUES. MEETING WITH COMMUNITY PARTNERS AND STAKEHOLDERS GUIDED THE PLANNING PROCESS. ADDITIONALLY, EACH PARTNER CREATED AN ORGANIZATION SPECIFIC PLAN TO ADDRESS THE SAME ISSUES. THE PLANS WERE TRANSCRIBED, PRESENTED AT A PRESS CONFERENCE, AND POSTED ON THE WEBSITE OF EACH PARTNER'S ORGANIZATION.6B: STRATEGIES FOR EACH OF THE FOUR TARGET AREAS WERE CREATED FOR THE COLLABORATIVE AND FOR DEACONESS. SINCE THE HOSPITAL SERVES VANDERBURGH AND WARRICK COUNTIES IN INDIANA, THE STRATEGY FOR DEACONESS INCLUDES TACTICS TO ADDRESS THESE ISSUES IN BOTH COMMUNITIES. AN INTERNAL TEAM LEADER WAS ASSIGNED TO EACH OF THE FOUR TOPIC AREAS AND RESPONSIBLE FOR PUTTING TOGETHER A TEAM AND THEN A PLAN TO CREATE POSITIVE CHANGE IN THE SPECIFIC HEALTH AREA. THE PLANNING PHASE IS COMPLETE AND THE EXECUTION PHASE TAKES PLACE IN TAX YEARS 2013, 2014, 2015.6C: MEMBERS OF THE DEACONESS COMMUNITY BENEFIT TEAM MET REGULARLY WITH OTHER MEMBERS OF THE COLLABORATIVE TO CREATE A STRATEGY AND TACTICS THAT ADDRESS OUR FOUR IDENTIFIED COMMUNITY HEALTH NEEDS. THE BENEFIT TEAM PARTICIPATED IN FOCUS GROUP SESSIONS WITH 51 BUSINESS, COMMUNITY, AND SOCIAL SERVICE LEADERS, AND STRATEGY SESSIONS WITH 42 PROVIDERS AND AGENCIES TO DEVELOP A PLAN THAT WOULD CAUSE POSITIVE CHANGE IN THE OVERALL HEALTH OF OUR POPULATION.6D: THE FIRST STEP IN EXECUTING OUR COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN WAS RELEASING INFORMATION TO THE PUBLIC. A PRESS CONFERENCE WAS HELD JUNE 13, 2013, AT A LOCAL BUSINESS. DURING THE PRESS CONFERENCE, REPRESENTATIVES FROM THE COLLABORATIVE EXPLAINED THE CHNA SURVEY PROCESS, RESULTS, CONTRIBUTIONS OF COMMUNITY PARTNERS, AND THE FOUR HEALTH ISSUES SELECTED AS OUR FOCUS FOR THE NEXT THREE YEARS. FOLLOWING THIS ANNOUNCEMENT, THE COLLABORATIVE SET UP MEETINGS FOR EACH OF THE FOUR HEALTH TOPICS AND INVITED ALL RELEVANT COMMUNITY PARTNERS TO ATTEND. DURING THESE MEETINGS, THE GROUP REVIEWS THE ACTION ITEMS IN THE IMPLEMENTATION PLAN, REPORTS ON THE PROGRESS OF THOSE ITEMS, AND ASKS FOR ASSISTANCE OR ADDITIONAL RESOURCES AS APPROPRIATE. 6G: MEMBERS OF OUR THREE KEY INFORMANT GROUPS (COMMUNITY LEADERS, BUSINESS LEADERS, AND SOCIAL SERVICE AGENCIES) SUBMITTED THEIR TOP 5 HEALTH PRIORITIES FOR THE COMMUNITY. THIS INFORMATION WAS COUPLED WITH THE SURVEY DATA RESULTING IN A LIST OF SEVEN KEY COMMUNITY HEALTH ISSUES. FOLLOWING FURTHER ANALYSIS, THE COLLABORATIVE DECIDED THAT TOBACCO USE, OBESITY, SUBSTANCE ABUSE, AND MENTAL HEALTH ISSUES WERE THE ROOT CAUSES OF MULTIPLE HEALTH CONDITIONS AND HIGHER HEALTH CARE COSTS. BY ADDRESSING THESE FOUR AREAS, THE COLLABORATIVE COULD HAVE THE BIGGEST IMPACT ON THE CURRENT HEALTH CONDITIONS IN OUR COMMUNITIES. 6H:AS PART OF OUR AGREEMENT WITH THE CHNA COLLABORATIVE, DEACONESS WILL FOCUS TIME AND RESOURCES FOR THE NEXT THREE YEARS ON CREATING POSITIVE CHANGE IN THE FOUR IDENTIFIED TOPIC AREAS. DEACONESS OPERATES AN ACCOUNTABLE CARE ORGANIZATION (ACO) CALLED DEACONESS CARE INTEGRATION. THE ACO HOUSES MANY OF THE PROGRAMS WE WILL USED TO ADDRESS OBESITY, TOBACCO USE, MENTAL HEALTH AND SUBSTANCE ABUSE. SPECIFIC SERVICES INCLUDE CERTIFICATION FOR ALL DEACONESS CLINIC LOCATIONS AS PATIENT CENTERED MEDICAL HOMES (PCMH), USE OF HEALTH COACHES IN THE PCMH, REFERRALS TO OUR MEDICATION MANAGEMENT PROGRAM, DIABETES MANAGEMENT PROGRAM, SUBSTANCE ABUSE, AND MENTAL HEALTH SERVICES (DEACONESS OPERATES A BEHAVIORAL HEALTH CLINIC AS WELL AS INPATIENT AND OUTPATIENT MENTAL HEALTH SERVICES.) THE DESIGN OF OUR ACO AND PCMH ENABLES STAFF MEMBERS TO EASILY ADDRESS THE FOUR IDENTIFIED COMMUNITY HEALTH NEEDS DURING ROUTINE OFFICE VISITS.DEACONESS HOSPITAL, INC.
PART V, SECTION B, LINE 6I: METHOD FOR ADDRESSING NEEDS IDENTIFIED IN CHNA:6A: IN 2011, DEACONESS HEALTH SYSTEM JOINED FOUR OTHER LOCAL HEALTH-RELATED ORGANIZATIONS, ECHO COMMUNITY HEALTH CARE, ST. MARY'S MEDICAL CENTER, UNITED WAY, AND WELBORN BAPTIST FOUNDATION, TO PLAN FOR AND ADMINISTER A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). REVIEW OF THE ASSESSMENT DATA LED THE TEAM TO IDENTIFY FOUR MAIN ISSUES AT THE CORE OF POOR COMMUNITY HEALTH: TOBACCO USE, OBESITY, SUBSTANCE ABUSE, AND MENTAL HEALTH. THE COLLABORATIVE CREATED A GROUP PLAN OF ACTION TO ADDRESS THE FOUR IDENTIFIED COMMUNITY HEALTH ISSUES. MEETING WITH COMMUNITY PARTNERS AND STAKEHOLDERS GUIDED THE PLANNING PROCESS. ADDITIONALLY, EACH PARTNER CREATED AN ORGANIZATION SPECIFIC PLAN TO ADDRESS THE SAME ISSUES. THE PLANS WERE TRANSCRIBED, PRESENTED AT A PRESS CONFERENCE, AND POSTED ON THE WEBSITE OF EACH PARTNER'S ORGANIZATION.6B: STRATEGIES FOR EACH OF THE FOUR TARGET AREAS WERE CREATED FOR THE COLLABORATIVE AND FOR DEACONESS. SINCE THE HOSPITAL SERVES VANDERBURGH AND WARRICK COUNTIES IN INDIANA, THE STRATEGY FOR DEACONESS INCLUDES TACTICS TO ADDRESS THESE ISSUES IN BOTH COMMUNITIES. AN INTERNAL TEAM LEADER WAS ASSIGNED TO EACH OF THE FOUR TOPIC AREAS AND RESPONSIBLE FOR PUTTING TOGETHER A TEAM AND THEN A PLAN TO CREATE POSITIVE CHANGE IN THE SPECIFIC HEALTH AREA. THE PLANNING PHASE IS COMPLETE AND THE EXECUTION PHASE TAKES PLACE IN TAX YEARS 2013, 2014, 2015.6C: MEMBERS OF THE DEACONESS COMMUNITY BENEFIT TEAM MET REGULARLY WITH OTHER MEMBERS OF THE COLLABORATIVE TO CREATE A STRATEGY AND TACTICS THAT ADDRESS OUR FOUR IDENTIFIED COMMUNITY HEALTH NEEDS. THE BENEFIT TEAM PARTICIPATED IN FOCUS GROUP SESSIONS WITH 51 BUSINESS, COMMUNITY, AND SOCIAL SERVICE LEADERS, AND STRATEGY SESSIONS WITH 42 PROVIDERS AND AGENCIES TO DEVELOP A PLAN THAT WOULD CAUSE POSITIVE CHANGE IN THE OVERALL HEALTH OF OUR POPULATION.6D: THE FIRST STEP IN EXECUTING OUR COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN WAS RELEASING INFORMATION TO THE PUBLIC. A PRESS CONFERENCE WAS HELD JUNE 13, 2013, AT A LOCAL BUSINESS. DURING THE PRESS CONFERENCE, REPRESENTATIVES FROM THE COLLABORATIVE EXPLAINED THE CHNA SURVEY PROCESS, RESULTS, CONTRIBUTIONS OF COMMUNITY PARTNERS, AND THE FOUR HEALTH ISSUES SELECTED AS OUR FOCUS FOR THE NEXT THREE YEARS. FOLLOWING THIS ANNOUNCEMENT, THE COLLABORATIVE SET UP MEETINGS FOR EACH OF THE FOUR HEALTH TOPICS AND INVITED ALL RELEVANT COMMUNITY PARTNERS TO ATTEND. DURING THESE MEETINGS, THE GROUP REVIEWS THE ACTION ITEMS IN THE IMPLEMENTATION PLAN, REPORTS ON THE PROGRESS OF THOSE ITEMS, AND ASKS FOR ASSISTANCE OR ADDITIONAL RESOURCES AS APPROPRIATE. 6G: MEMBERS OF OUR THREE KEY INFORMANT GROUPS (COMMUNITY LEADERS, BUSINESS LEADERS, AND SOCIAL SERVICE AGENCIES) SUBMITTED THEIR TOP 5 HEALTH PRIORITIES FOR THE COMMUNITY. THIS INFORMATION WAS COUPLED WITH THE SURVEY DATA RESULTING IN A LIST OF SEVEN KEY COMMUNITY HEALTH ISSUES. FOLLOWING FURTHER ANALYSIS, THE COLLABORATIVE DECIDED THAT TOBACCO USE, OBESITY, SUBSTANCE ABUSE, AND MENTAL HEALTH ISSUES WERE THE ROOT CAUSES OF MULTIPLE HEALTH CONDITIONS AND HIGHER HEALTH CARE COSTS. BY ADDRESSING THESE FOUR AREAS, THE COLLABORATIVE COULD HAVE THE BIGGEST IMPACT ON THE CURRENT HEALTH CONDITIONS IN OUR COMMUNITIES. 6H:AS PART OF OUR AGREEMENT WITH THE CHNA COLLABORATIVE, DEACONESS WILL FOCUS TIME AND RESOURCES FOR THE NEXT THREE YEARS ON CREATING POSITIVE CHANGE IN THE FOUR IDENTIFIED TOPIC AREAS. DEACONESS OPERATES AN ACCOUNTABLE CARE ORGANIZATION (ACO) CALLED DEACONESS CARE INTEGRATION. THE ACO HOUSES MANY OF THE PROGRAMS WE WILL USED TO ADDRESS OBESITY, TOBACCO USE, MENTAL HEALTH AND SUBSTANCE ABUSE. SPECIFIC SERVICES INCLUDE CERTIFICATION FOR ALL DEACONESS CLINIC LOCATIONS AS PATIENT CENTERED MEDICAL HOMES (PCMH), USE OF HEALTH COACHES IN THE PCMH, REFERRALS TO OUR MEDICATION MANAGEMENT PROGRAM, DIABETES MANAGEMENT PROGRAM, SUBSTANCE ABUSE, AND MENTAL HEALTH SERVICES (DEACONESS OPERATES A BEHAVIORAL HEALTH CLINIC AS WELL AS INPATIENT AND OUTPATIENT MENTAL HEALTH SERVICES.) THE DESIGN OF OUR ACO AND PCMH ENABLES STAFF MEMBERS TO EASILY ADDRESS THE FOUR IDENTIFIED COMMUNITY HEALTH NEEDS DURING ROUTINE OFFICE VISITS.DEACONESS GATEWAY HOSPITAL
PART V, SECTION B, LINE 6I: METHOD FOR ADDRESSING NEEDS IDENTIFIED IN CHNA:6A: IN 2011, DEACONESS HEALTH SYSTEM JOINED FOUR OTHER LOCAL HEALTH-RELATED ORGANIZATIONS, ECHO COMMUNITY HEALTH CARE, ST. MARY'S MEDICAL CENTER, UNITED WAY, AND WELBORN BAPTIST FOUNDATION, TO PLAN FOR AND ADMINISTER A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). REVIEW OF THE ASSESSMENT DATA LED THE TEAM TO IDENTIFY FOUR MAIN ISSUES AT THE CORE OF POOR COMMUNITY HEALTH: TOBACCO USE, OBESITY, SUBSTANCE ABUSE, AND MENTAL HEALTH. THE COLLABORATIVE CREATED A GROUP PLAN OF ACTION TO ADDRESS THE FOUR IDENTIFIED COMMUNITY HEALTH ISSUES. MEETING WITH COMMUNITY PARTNERS AND STAKEHOLDERS GUIDED THE PLANNING PROCESS. ADDITIONALLY, EACH PARTNER CREATED AN ORGANIZATION SPECIFIC PLAN TO ADDRESS THE SAME ISSUES. THE PLANS WERE TRANSCRIBED, PRESENTED AT A PRESS CONFERENCE, AND POSTED ON THE WEBSITE OF EACH PARTNER'S ORGANIZATION.6B: STRATEGIES FOR EACH OF THE FOUR TARGET AREAS WERE CREATED FOR THE COLLABORATIVE AND FOR DEACONESS. SINCE THE HOSPITAL SERVES VANDERBURGH AND WARRICK COUNTIES IN INDIANA, THE STRATEGY FOR DEACONESS INCLUDES TACTICS TO ADDRESS THESE ISSUES IN BOTH COMMUNITIES. AN INTERNAL TEAM LEADER WAS ASSIGNED TO EACH OF THE FOUR TOPIC AREAS AND RESPONSIBLE FOR PUTTING TOGETHER A TEAM AND THEN A PLAN TO CREATE POSITIVE CHANGE IN THE SPECIFIC HEALTH AREA. THE PLANNING PHASE IS COMPLETE AND THE EXECUTION PHASE TAKES PLACE IN TAX YEARS 2013, 2014, 2015.6C: MEMBERS OF THE DEACONESS COMMUNITY BENEFIT TEAM MET REGULARLY WITH OTHER MEMBERS OF THE COLLABORATIVE TO CREATE A STRATEGY AND TACTICS THAT ADDRESS OUR FOUR IDENTIFIED COMMUNITY HEALTH NEEDS. THE BENEFIT TEAM PARTICIPATED IN FOCUS GROUP SESSIONS WITH 51 BUSINESS, COMMUNITY, AND SOCIAL SERVICE LEADERS, AND STRATEGY SESSIONS WITH 42 PROVIDERS AND AGENCIES TO DEVELOP A PLAN THAT WOULD CAUSE POSITIVE CHANGE IN THE OVERALL HEALTH OF OUR POPULATION.6D: THE FIRST STEP IN EXECUTING OUR COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN WAS RELEASING INFORMATION TO THE PUBLIC. A PRESS CONFERENCE WAS HELD JUNE 13, 2013, AT A LOCAL BUSINESS. DURING THE PRESS CONFERENCE, REPRESENTATIVES FROM THE COLLABORATIVE EXPLAINED THE CHNA SURVEY PROCESS, RESULTS, CONTRIBUTIONS OF COMMUNITY PARTNERS, AND THE FOUR HEALTH ISSUES SELECTED AS OUR FOCUS FOR THE NEXT THREE YEARS. FOLLOWING THIS ANNOUNCEMENT, THE COLLABORATIVE SET UP MEETINGS FOR EACH OF THE FOUR HEALTH TOPICS AND INVITED ALL RELEVANT COMMUNITY PARTNERS TO ATTEND. DURING THESE MEETINGS, THE GROUP REVIEWS THE ACTION ITEMS IN THE IMPLEMENTATION PLAN, REPORTS ON THE PROGRESS OF THOSE ITEMS, AND ASKS FOR ASSISTANCE OR ADDITIONAL RESOURCES AS APPROPRIATE. 6G: MEMBERS OF OUR THREE KEY INFORMANT GROUPS (COMMUNITY LEADERS, BUSINESS LEADERS, AND SOCIAL SERVICE AGENCIES) SUBMITTED THEIR TOP 5 HEALTH PRIORITIES FOR THE COMMUNITY. THIS INFORMATION WAS COUPLED WITH THE SURVEY DATA RESULTING IN A LIST OF SEVEN KEY COMMUNITY HEALTH ISSUES. FOLLOWING FURTHER ANALYSIS, THE COLLABORATIVE DECIDED THAT TOBACCO USE, OBESITY, SUBSTANCE ABUSE, AND MENTAL HEALTH ISSUES WERE THE ROOT CAUSES OF MULTIPLE HEALTH CONDITIONS AND HIGHER HEALTH CARE COSTS. BY ADDRESSING THESE FOUR AREAS, THE COLLABORATIVE COULD HAVE THE BIGGEST IMPACT ON THE CURRENT HEALTH CONDITIONS IN OUR COMMUNITIES. 6H:AS PART OF OUR AGREEMENT WITH THE CHNA COLLABORATIVE, DEACONESS WILL FOCUS TIME AND RESOURCES FOR THE NEXT THREE YEARS ON CREATING POSITIVE CHANGE IN THE FOUR IDENTIFIED TOPIC AREAS. DEACONESS OPERATES AN ACCOUNTABLE CARE ORGANIZATION (ACO) CALLED DEACONESS CARE INTEGRATION. THE ACO HOUSES MANY OF THE PROGRAMS WE WILL USED TO ADDRESS OBESITY, TOBACCO USE, MENTAL HEALTH AND SUBSTANCE ABUSE. SPECIFIC SERVICES INCLUDE CERTIFICATION FOR ALL DEACONESS CLINIC LOCATIONS AS PATIENT CENTERED MEDICAL HOMES (PCMH), USE OF HEALTH COACHES IN THE PCMH, REFERRALS TO OUR MEDICATION MANAGEMENT PROGRAM, DIABETES MANAGEMENT PROGRAM, SUBSTANCE ABUSE, AND MENTAL HEALTH SERVICES (DEACONESS OPERATES A BEHAVIORAL HEALTH CLINIC AS WELL AS INPATIENT AND OUTPATIENT MENTAL HEALTH SERVICES.) THE DESIGN OF OUR ACO AND PCMH ENABLES STAFF MEMBERS TO EASILY ADDRESS THE FOUR IDENTIFIED COMMUNITY HEALTH NEEDS DURING ROUTINE OFFICE VISITS.DEACONESS CROSS POINTE
PART V, SECTION B, LINE 14G: OTHER METHOD USED TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY: DEACONESS HOSPITAL SEEKS OUT THE PATIENTS THAT ARE SELF-PAY AND INTERVIEWS THESE PATIENTS WHILE THEY ARE IN THE FACILITY. THE FINANCIAL ASSISTANCE POLICY IS PROMOTED TO PATIENTS. DEACONESS HOSPITAL SEEKS OUT THOSE PATIENTS THAT WOULD QUALIFY FOR THE FINANCIAL ASSISTANCE POLICY. COLLECTABILITY SCORING IS ALSO COMPLETED AND ALLOWANCES ARE MADE BASED UPON THESE SCORES.DEACONESS HOSPITAL, INC.
PART V, SECTION B, LINE 14G: OTHER METHOD USED TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY: DEACONESS HOSPITAL SEEKS OUT THE PATIENTS THAT ARE SELF-PAY AND INTERVIEWS THESE PATIENTS WHILE THEY ARE IN THE FACILITY. THE FINANCIAL ASSISTANCE POLICY IS PROMOTED TO PATIENTS. DEACONESS HOSPITAL SEEKS OUT THOSE PATIENTS THAT WOULD QUALIFY FOR THE FINANCIAL ASSISTANCE POLICY. COLLECTABILITY SCORING IS ALSO COMPLETED AND ALLOWANCES ARE MADE BASED UPON THESE SCORES.DEACONESS GATEWAY HOSPITAL
PART V, SECTION B, LINE 14G: OTHER METHOD USED TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY: DEACONESS HOSPITAL SEEKS OUT THE PATIENTS THAT ARE SELF-PAY AND INTERVIEWS THESE PATIENTS WHILE THEY ARE IN THE FACILITY. THE FINANCIAL ASSISTANCE POLICY IS PROMOTED TO PATIENTS. DEACONESS HOSPITAL SEEKS OUT THOSE PATIENTS THAT WOULD QUALIFY FOR THE FINANCIAL ASSISTANCE POLICY. COLLECTABILITY SCORING IS ALSO COMPLETED AND ALLOWANCES ARE MADE BASED UPON THESE SCORES.DEACONESS CROSS POINTE
PART V, SECTION B, LINE 20D: DEACONESS USES ITS AVERAGE MANAGED CARE NEGOTIATED DISCOUNT FOR ALL COMMERCIAL PAYERS.DEACONESS HOSPITAL, INC.
PART V, SECTION B, LINE 20D: DEACONESS USES ITS AVERAGE MANAGED CARE NEGOTIATED DISCOUNT FOR ALL COMMERCIAL PAYERS.DEACONESS GATEWAY HOSPITAL
PART V, SECTION B, LINE 20D: DEACONESS USES ITS AVERAGE MANAGED CARE NEGOTIATED DISCOUNT FOR ALL COMMERCIAL PAYERS.DEACONESS CROSS POINTE
PART VI, LINE 2: NEEDS ASSESSMENT PROCESS: IN ADDITION TO THE CHNA REPORTED IN PART V, SECTION B DEACONESS HOSPITAL UTILIZES A VARIETY OF SOURCES TO GATHER DATA ON LOCAL HEALTH CARE NEEDS. A MAJOR SOURCE IS THE 7-COUNTY HEALTH SURVEY CONDUCTED BY WELBORN BAPTIST FOUNDATION. DEACONESS ALSO USES DATA FROM THE UNITED WAY OF SOUTHWESTERN INDIANA'S COMPREHENSIVE NEEDS ASSESSMENT, COUNTY HEALTH RANKINGS WEBSITE, INDIANA STATE DEPARTMENT OF HEALTH, CENTERS FOR DISEASE CONTROL AND PREVENTION, NATIONAL CENTER FOR HEALTH STATISTICS, AND THE U.S. CENSUS BUREAU. ADDITIONAL INFORMATION COMES THROUGH THE HOSPITAL'S INTERACTION WITH LOCAL SERVICE PROVIDERS AND OTHER NON-PROFIT ORGANIZATIONS. THE COMMITTEE USES A DYNAMIC, ONGOING PROCESS TO INCLUDE A REVIEW OF PREVIOUS OR CURRENT ASSESSMENTS BY OTHER COMMUNITY GROUPS, PRESENTATIONS MADE BY OUTSIDE GROUPS SOLICITING DEACONESS HOSPITAL'S INVOLVEMENT IN COMMUNITY INITIATIVES, REVIEW OF HEALTH AND DEMOGRAPHIC INFORMATION OF INPATIENTS AND OUTPATIENTS, AND ANALYSIS OF INFORMATION FROM OUTSIDE ORGANIZATIONS AND INTERNAL RECORDS TO IDENTIFY TRENDS AND AREAS OF CONCERN REQUIRING ATTENTION.
PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: DEACONESS HOSPITAL UTILIZES FINANCIAL COUNSELORS TO EDUCATE, INFORM AND ASSIST PATIENTS AND FAMILIES IN UNDERSTANDING THEIR FINANCIAL OBLIGATION, ABILITY TO QUALIFY FOR FINANCIAL ASSISTANCE THROUGH DEACONESS HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM AND PAYMENT OPTIONS. SPECIFICALLY, FINANCIAL COUNSELORS STAFF THE EMERGENCY DEPARTMENT, REGISTRATION AREAS, CASHIER AREA, AS WELL AS, FLOAT AMONG INPATIENT AREAS TO ENSURE EACH AND EVERY PATIENT REQUIRING ASSISTANCE IS REACHED. IN ADDITION TO THE PERSONAL AND INDIVIDUALIZED COUNSELING PROVIDED BY THE FINANCIAL COUNSELORS, VARIOUS FORMS OF MEDIA ARE DISTRIBUTED THROUGHOUT DEACONESS HOSPITAL EXPLAINING THE FINANCIAL ASSISTANCE PROCESS. ADDITIONALLY, POLICIES FOR FINANCIAL ASSISTANCE ARE POSTED WIDELY THROUGHOUT DEACONESS HOSPITAL AND ON THE INTERNET AT WWW.DEACONESS.COM. HTTP://WWW.DEACONESS.COM/DEACONESSHOSPITAL/BUSINESS-OFFICE/FINANCIAL-ASSISTANCE.ASPX
PART VI, LINE 4: COMMUNITY INFORMATION: DEACONESS HOSPITAL IS A MAJOR REFERRAL CENTER FOR A 25-COUNTY TRI-STATE AREA IN SOUTHWESTERN INDIANA, WESTERN KENTUCKY AND SOUTHEASTERN ILLINOIS. THE HOSPITAL AND ITS FACILITIES ARE LOCATED ON FOUR CAMPUSES WHICH INCLUDE THE MAIN 28-ACRE CAMPUS ON THE NEAR NORTH SIDE OF EVANSVILLE IN VANDERBURGH COUNTY; THE 63-ACRE GATEWAY CAMPUS LOCATED IN WARRICK COUNTY ON THE EASTERN BORDER OF VANDERBURGH COUNTY; AND TWO OTHER EASTSIDE EVANSVILLE LOCATIONS FOR PSYCHIATRIC BEHAVIORAL SERVICES AND REHABILITATION SERVICES. THE HOSPITAL OPERATES A MAIN CAMPUS WITH A TOTAL OF 305 BEDS CONSISTING OF 38 INTENSIVE CARE BEDS, 16 CARDIAC INTENSIVE CARE BEDS, 66 CARDIAC BEDS, 23 ONCOLOGY/ PULMONOLOGY BEDS, 61 ORTHOPAEDIC/ NEUROLOGICAL BEDS, 96 MEDICAL/ SURGICAL BEDS AND 5 HOSPICE BEDS. IN ADDITION, THE HOSPITAL PROVIDES A FULL-ARRAY OF COMPREHENSIVE OUTPATIENT AND AMBULATORY SERVICES ON ITS MAIN CAMPUS AND OTHER SPECIFIC SERVICES AT MULTIPLE SITES WITHIN ITS PRIMARY AND SECONDARY SERVICE AREAS. THE HOSPITAL OPERATES THE 158 BED DEACONESS GATEWAY HOSPITAL WHICH WAS OPENED IN JANUARY 2006, ON THE GATEWAY CAMPUS CONSISTING OF 13 ADULT INTENSIVE CARE BEDS, 17 PEDIATRIC AND PEDIATRIC INTENSIVE CARE BEDS, 16 NEUROSURGICAL BEDS, 32 ORTHOPAEDIC BEDS, 16 NEURO INTENSIVE CARE BEDS, 32 SURGICAL ONCOLOGY BEDS, AND 32 GENERAL MED/ TELEMETRY BEDS. THE HOSPITAL PROVIDES A FULL ARRAY OF COMPREHENSIVE OUTPATIENT AND AMBULATORY SERVICE ON THE GATEWAY CAMPUS. THE HOSPITAL OWNS AND OPERATES DEACONESS CROSS POINTE, A FREE-STANDING, 60-BED INPATIENT PSYCHIATRIC HOSPITAL LOCATED APPROXIMATELY 7 MILES EAST OF THE MAIN CAMPUS IN EVANSVILLE. ALSO, THE HOSPITAL IS AN OWNER IN THREE JOINT VENTURE HOSPITALS:1. DEACONESS WOMEN'S HOSPITAL OF SOUTHERN INDIANA, LLC D/B/A THE WOMEN'S HOSPITAL, A FREE STANDING SPECIALTY 74-BED WOMEN'S AND INFANT'S HOSPITAL, LOCATED ON THE GATEWAY CAMPUS.2. HEALTHSOUTH/DEACONESS, LLC D/B/A TRI-STATE REGIONAL REHABILITATION HOSPITAL, A 80-BED INPATIENT ACUTE REHABILITATION HOSPITAL, LOCATED APPROXIMATELY 8 MILES TO THE SOUTHEAST OF THE MAIN CAMPUS.3. THE HEART HOSPITAL AT DEACONESS GATEWAY, LLC, A 24-BED CARDIOVASCULAR SPECIALTY HOSPITAL, RESIDING ON THE GATEWAY CAMPUS. THE HOSPITAL PLAYS AN ACTIVE ROLE IN MEDICAL EDUCATION, OPERATING A THREE YEAR FAMILY MEDICINE RESIDENCY PROGRAM, A POST-GRADUATE PHARMACY RESIDENT PROGRAM, AND SEVERAL UNDERGRADUATE MEDICAL AFFILIATIONS. THE HOSPITAL ALSO PROVIDES CONTINUING MEDICAL EDUCATION PROGRAMS FOR ATTENDING PHYSICIANS, OTHER HEALTH PROFESSIONALS, OTHER ALLIED HEALTH PROGRAMS, AND THE COMMUNITY AT LARGE. THE HOSPITAL, THROUGH ITS RELATED CORPORATIONS, PROVIDES OUTREACH SERVICES TO NURSING HOMES, PHYSICIANS' OFFICES AND SURROUNDING SMALLER HOSPITALS IN ITS SERVICE AREA.VANDERBURGH COUNTY DEMOGRAPHICS INCLUDE:POPULATION: VANDERBURGH COUNTY INCLUDES A POPULATION OF 183,833 PEOPLE, A NUMBER THAT IS EXPECTED TO REMAIN RELATIVELY FLAT OVER THE NEXT 5 YEARS. WITHIN VANDERBURGH, ONE OF THE MOST SIGNIFICANT GROWTH SEGMENTS IS THE 65+ AGE POPULATION, WHERE AN 8.8% INCREASE IS PROJECTED FOR THE 5-YEAR PERIOD BETWEEN 2012 AND 2017. MARKET DIVERSITY: THE EVANSVILLE AREA CONTINUES TO BE A RELATIVELY NON-DIVERSE POPULATION, WITH 86% OF THE POPULATION CHARACTERIZED AS WHITE OR CAUCASIAN ALONE AND 9% OF THE POPULATION CHARACTERIZED AS BLACK OR AFRICAN AMERICAN ALONE.POOR AND VULNERABLE POPULATIONS: ONE OUT OF SEVEN HOUSEHOLDS IN VANDERBURGH (15.1%) EARNS LESS THAN $15,000 ANNUALLY. IT IS ESTIMATED THAT 15.9% OF RESIDENTS ARE UNINSURED, A NUMBER THAT IS PROJECTED TO DECLINE TO 7.5% BY 2017, ASSUMING THAT THE EXPANSION OF MEDICAID TAKES PLACE AS ORIGINALLY SCHEDULED.HEALTH OUTCOMES: BASED ON THE 2012 COUNTY HEALTH RAKINGS, VANDERBURGH COUNTY RANKS 76TH OUT OF 92 INDIANA COUNTIES BASED ON SPECIFIC HEALTH FACTORS AND HEALTH OUTCOMES. IT RANKS 78TH RELATIVE TO ITS PHYSICAL ENVIRONMENT (E.G. AIR POLLUTION). (SOURCE: ROBERT WOODS JOHNSON FOUNDATION, ACCESSED AT WWW.COUNTYHEALTHRANKINGS.ORG). HOUSEHOLD INCOME: THE MEDIAN HOUSEHOLD INCOME IN VANDERBURGH COUNTY IS ESTIMATED AT $38,851 FOR 2012.MEDIAN AGE: THE MEDIAN AGE IN VANDERBURGH DURING 2012 WAS 38 YEARS.WARRICK COUNTY DEMOGRAPHICS INCLUDE:POPULATION: WARRICK COUNTY INCLUDES A POPULATION OF 61,138 PEOPLE, A NUMBER THAT IS EXPECTED TO GROW BY MORE THAN 5% OVER THE NEXT 5 YEARS. WITHIN WARRICK, ONE OF THE MOST SIGNIFICANT GROWTH SEGMENTS IS THE 65+ AGE POPULATION, WHERE A 27.8% INCREASE IS PROJECTED FOR THE 5-YEAR PERIOD BETWEEN 2012 AND 2017. MARKET DIVERSITY: THE WARRICK AREA CONTINUES TO BE A RELATIVELY NON-DIVERSE POPULATION, WITH 95% OF THE POPULATION CHARACTERIZED AS WHITE OR CAUCASIAN ALONE.POOR AND VULNERABLE POPULATIONS: A RELATIVELY AFFLUENT POPULATION, ONLY 8% OF WARRICK'S HOUSEHOLDS EARNS LESS THAN $15,000 ANNUALLY. IT IS ESTIMATED THAT 7% OF RESIDENTS ARE UNINSURED, A NUMBER THAT IS PROJECTED TO DECLINE TO 3% BY 2017, ASSUMING THAT THE EXPANSION OF MEDICAID TAKES PLACE AS ORIGINALLY SCHEDULED.HEALTH OUTCOMES: BASED ON THE 2012 COUNTY HEALTH RAKINGS, WARRICK COUNTY RANKS 11TH OUT OF 92 INDIANA COUNTIES BASED ON SPECIFIC HEALTH FACTORS AND HEALTH OUTCOMES. IT RANKS 85TH BASED ON ITS PHYSICAL ENVIRONMENT (E.G. AIR POLLUTION). HOUSEHOLD INCOME: THE MEDIAN HOUSEHOLD INCOME IN WARRICK COUNTY IS ESTIMATED AT $47,922 FOR 2012.MEDIAN AGE: THE MEDIAN AGE IN WARRICK DURING 2012 WAS 40 YEARS.
PART VI, LINE 5: OTHER IMPORTANT COMMUNITY HEALTH PROMOTION:THE ORGANIZATION FURTHERS ITS EXEMPT PURPOSE BY PROMOTING HEALTH OF THE COMMUNITY INCLUDES: A MAJORITY OF ORGANIZATION'S GOVERNING BODY IS INDEPENDENT AND COMPRISED OF PERSONS WHO RESIDED IN THE ORGANIZATION'S PRIMARY SERVICE AREA; EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY; AND APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE.
PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:DEACONESS HOSPITAL WORKS IN CONCERT WITH DEACONESS HEALTH SYSTEM AND DEACONESS CLINIC TO PROVIDE HEALTHCARE SERVICES WITH A COMPASSIONATE AND CARING SPIRIT TO PERSONS, FAMILIES AND COMMUNITIES OF THE TRI-STATE. DEACONESS HEALTH SYSTEM WORKS TO INCREASE ACCESS TO HEALTHCARE SERVICES WITHIN OUR COMMUNITY THROUGH DEACONESS HOSPITAL AND DEACONESS CLINIC. DEACONESS HOSPITAL IS A MEDICAL INSTITUTION DEDICATED TO PROVIDING QUALITY PATIENT CARE WITH UNRELENTING ATTENTION TO CLINICAL EXCELLENCE, PATIENT SAFETY AND AN UNPARALLELED PASSION AND COMMITMENT TO ASSURE THE VERY BEST HEALTHCARE FOR THE PATIENTS SERVED. DEACONESS CLINIC PROVIDES EXCELLENT PRIMARY AND MULTI-SPECIALTY HEALTHCARE IN A PERSONALIZED FASHION WITH A DEDICATED FOCUS TO SERVE THE COMMUNITY WITH EXCELLENT, TIMELY AND COMPASSIONATE PATIENT CARE.PART VI, LINE 7, LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: INDIANA

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (23 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
GILDA'S CLUB EVANSVILLE INC
PO BOX 5134EVANSVILLEIN47716261932741384431CAPITAL CAMPAIGN
EVANSVILLE MUSEUM OF ARTS AND SCIENCE
411 SE RIVERSIDE DREVANSVILLEIN47713350874517341500CAPITAL CAMPAIGN
YMCA OF SW INDIANA INC
222 NW 6TH STEVANSVILLEIN47708350869074326750GENERAL SUPPORT
MARIAN UNIVERSITY
3200 COLD SPRING ROADINDIANAPOLISIN462221997350868175325000D.O. SCHOLARSHIP PROGRAM
IVY TECH FOUNDATION
3501 N 1ST AVENUEEVANSVILLEIN47710237073977324600GENERAL SUPPORT
CHILDREN'S MUSEUM OF EVANSVILLE
PO BOX 122EVANSVILLEIN477010074351951848321500GENERAL SUPPORT
JUVENILE DIABETES
10401 N MERIDIAN ST SUITE 150INDIANAPOLISIN46290231907729315000GENERAL SUPPORT
KOMEN GREATER EVANSVILLE AFFILIATE
4424 VOGEL RD STE 205EVANSVILLEIN47715752844632315000GENERAL SUPPORT
YWCA
118 VINE STEVANSVILLEIN47708350869075312500GENERAL SUPPORT
EVANSVILLE AREA COMMUNITY CHURCHES
713 N 2ND AVEEVANSVILLEIN47710350886837312000FOOD FOR FOOD PANTRY
AURORA
1100 LINCOLN AVE PO BOX 74EVANSVILLEIN477010074351759576310000CAPITAL CAMPAIGN
EVANSVILLE SOCCER CLUB
PO BOX 15906EVANSVILLEIN47716352086976310000UNDERSERVED YOUTH
HABITAT FOR HUMANITY
1401 N FARES AVENUEEVANSVILLEIN47711351602775310000GENERAL SUPPORT
EVANSVILLE KIDNEY ASSOCIATION
1312 PROFESSIONAL BLVD STE 200EVANSVILLEIN4771426021976539224GENERAL SUPPORT
CONGREGATIONS OF ACTING FOR JUSTICE
713 N 2ND AVEEVANSVILLEIN4771030005121738000GENERAL SUPPORT
GIRL SCOUTS OF SOUTHWEST INDIANA
223 NW 2ND STREETEVANSVILLEIN4770835087638038000GENERAL SUPPORT
UNITED WAY OF SW INDIANA
PO BOX 18EVANSVILLEIN4770135086806938000GENERAL SUPPORT
EASTER SEALS REHABILITATION CENTER
3701 BELLEMEADE AVEEVANSVILLEIN4771435108752637925GENERAL SUPPORT
AMERICAN CANCER SOCIETY
5250 VOGEL RD SUITE AEVANSVILLEIN4771513178849137572GENERAL SUPPORT
KEEP EVANSVILLE BEAUTIFUL
209 MAIN STREETEVANSVILLEIN4770835144938136555GENERAL SUPPORT
TOUCH INC
2401 E CHANDLER AVEEVANSVILLEIN4771426398976836112GENERAL SUPPORT
AMERICAN RED CROSS
29 S STOCKWELL RDEVANSVILLEIN4771453019660535100GENERAL SUPPORT
OTHERS 5000
203619GENERAL SUPPORT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants22TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: DEACONESS HOSPITAL CONFIRMS ALL RECIPIENTS OF FUNDS ARE ORGAANIZATIONS WHOSE GOALS COINCIDE WITH DEACONESS' MISSION OF PROVIDING QUALITY HEALTH CARE WITH A COMPASSIONATE AND CARING SPIRIT. THE ORGANIZATIONS PROVIDE NEEDED SERVICES TO OUR COMMUNITY TO IMPROVE HEALTH AND WELLNESS FOR THE CITIZENS IN THE SURROUNDING AREA.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs1CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (20 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
LINDA E WHITE
PRESIDENT/ CEO31141431744132030409668680013809383645102151021578969441810100
DAVID A KOEHLER JR MD
DIRECTOR81606144298970922921670072001397704439801518235900
MATHIAS KOLLECK II
DIRECTOR2183420549870518790212710237700370249000
SHAWN W MCCOY
CHIEF ADMINISTRATIVE OFFIC3415600155831033519000921320273730620247900000
CHERYL A WATHEN
CHIEF FINANCIAL OFFICER1560461625001218750485688003886627563204562045634209921931900
JAMES R PORTER MD
CHIEF MEDICAL OFFICER38050301438560185128001043260267350657271280000
CHERONA J HAJEWSKI
CHIEF NURSING OFFICER2690580102740067310576160259690462114000
BRUCE E EPMEIER
VICE PRESIDENT19858807584606080305017001936004047670571020
LARRY F PILE
HR DIRECTOR94445034453015071322053929078030291343220500
LYNN C LINGAFELTER
DIRECTOR ER/SURGICAL172162032485025002565004430230990000
RICHARD B PERRY
CONTROLLER144423062616011310132910168880238349000
JOHN L ZABROWSKI
CONTROLLER172401033855015313000144710262570248515300000
JOYCE A THOMAS
PHARMACY DIRECTOR142560029232016110267560230100223169000
REBECCA L MALOTTE
EXEC. DIRECTOR, CNO142470033740010630403600142630231896000
VENKATESH R MADADI
ANESTHESIOLOGIST631337000494810371160190200736954000
NIRMAL JOSHI MD
ANESTHESIOLOGIST651704000707020393510211930782950000
RAJESH J PATEL MD
ANESTHESIOLOGIST699301000439560144120201830777852000
AYMAN ELFAR MD
ANESTHESIOLOGIST560800000323810322330195970645011000
LAWRENCE C KILINSKI JR MD
ANESTHESIOLOGIST551067000433980333090203500648124000
HARRY L SMITH JR
FORMER PRESIDENT TERM. JAN000039273502376102001504365110190770

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1ASOCIAL CLUB DUES ARE PAID FOR LINDA WHITE, JAMES PORTER AND SHAWN MCCOY FOR ORGANIZATION BUSINESS ONLY. ANY PERSONAL USE OF THE CLUB MUST BE PAID BY THE EMPLOYEES.
PART I, LINES 4A-BSEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS: SEVERANCE NONQUALIFIED EQUITY-BASED LINDA E. WHITE $ -0- $17,000 $ -0- DAVID A. KOEHLER, JR., MD. 0 17,000 0 SHAWN W. MCCOY 0 17,000 0 JAMES R. PORTER, MD. 0 17,000 0 CHERONA J. HAJEWSKI 0 17,000 0 BRUCE E. EPMEIER 0 17,000 0 VENKATESH R. MADADI, MD. 0 17,000 0 RAJESH J. PATEL, MD. 0 17,000 0 LAWRENCE C. KILINSKI, JR., MD. 0 17,000 0 CHERYL A. WATHEN 0 17,000 0 HARRY L. SMITH, JR. 374,762 0 0 PART I, 4B: CONTRIBUTIONS MADE TO A SUPPLEMENTAL ACCUMULATION ACCOUNT LINDA WHITE: $206,738. SHAWN MCCOY: $77,132. CHERYL WATHEN: $51,429. JAMES PORTER: $89,326. BRUCE EPMEIER: $36,184 CHERONA HAJEWSKI: $42,616. HARRY SMITH: $19,077. PAYOUT FROM A SUPPLEMENTAL ACCUMULATION ACCOUNT BRUCE EPMEIER: $57,102.
PART I, LINE 6RELATED ORG. COMPENSATION CONTINGENT UPON NET EARNINGS INCENTIVE COMPENSATION PAYMENTS ARE BASED UPON SUCCESSFUL ACHIEVEMENT OF ESTABLISHED INPATIENT SATISFACTION MEASURES, OUTPATIENT SATISFACTION MEASURES, COMPLIANCE WITH PUBLICLY REPORTED QUALITY INDICATORS, OPERATING MARGIN AS WELL AS OTHER TECHNICAL AND PERSONAL FUNCTIONAL GOALS. DEACONESS HOSPITAL'S INCENTIVE COMPENSATION PROGRAMS ARE FORMULATED TO REWARD BEHAVIOR THAT BALANCES PATIENT NEEDS AND EFFICIENT DELIVERY OF PATIENT CARE TO ENSURE THE BEST OUTCOMES ARE ACHIEVED.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
INDIANA FINANCE AUTHORITY
A35160231645471AAK82009-03-2655914771FACILITY CONSTRUCTION000
INDIANA FINANCE AUTHORITY
B35160231645471AFF42011-12-02206671973/15/99 REFUNDING000
INDIANA FINANCE AUTHORITY
C3516023162012-11-20130050001992 REFUNDING000
INDIANA FINANCE AUTHORITY
D35160231645471ALU42013-07-23401800003/29/09 REFUNDING000

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A1344000055914771563680657338418280734306162069975920110011
B20667197397197202700001011
C13005000103657129013431011
D40180000180000400000001011

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersTotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrsPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI
A01000.009000.00900001
B0000001
C0000001
D00000.009000.009000010.00000

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICTerm Of GICTermOfGICRegulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfiedGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
TRINITY PLUS
A01000012.000000000000101
(no name)
B00100001
(no name)
C010000001
(no name)
D000000001

Form990 Schedule K Part V Form990ScheduleKPartV (4 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A1
B1
C1
D1

Form990 Schedule K Part VI Form990ScheduleKPartVI (3 entries)

IdentifierIdentifierExplanationExplanation
SCHEDULE K, PART II, COLUMN A (WORKSHEET 1), LINE 1AMOUNT OF BONDS RETIRED: $13,440,000 OF THE ORIGINAL ISSUED PRINCIPAL AMOUNT OF THE 2009A BOND ISSUED 3/26/1999 WAS ADVANCED REFUNDED BY THE 2013A BOND ISSUE.
SCHEDULE K, PART II, COLUMN A (WORKSHEET 1), LINE 11OTHER SPENT PROCEEDS THE OTHER SPENT PROCEEDS ARE THE CURRENT REFUNDING PROCEEDS OF THE BOND ISSUE.
SCHEDULE K, PART II, COLUMN A (WORKSHEET 2), LINE 6PROCEEDS IN REFUNDING ESCROW: THE PROCEEDS IN COLUMN A ON THE 2ND WORKSHEET K WILL BE USED ON 3/1/14 TO REFUND THE 2009A AND 2004A BOND ISSUES.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
INDIANA FINANCE AUTHORITY
A35160231645471AKY72013-03-05713361685/27/04 AND 3/26/09 REFUNDING000
INDIANA FINANCE AUTHORITY
B3516023162013-03-05214400005/27/04 REFUNDING000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindOther Spent ProceedsOtherSpentProceeds
A71336168706066317295380111
B21440000125000101121315000

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A01000.002000.000000.00200001
B01000.000000.007000.00700001

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqsTerm Of HedgeTermOfHedgeSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminated
(no name)
A010000001
FIFTH THIRD
B01000100116.00000000000000

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A1
B1

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (9 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
NANCY KOEHLER
FAMILY OF BD MBR130892COMP.0
ANN TORNATTA
FAMILY OF BD MBR109033COMP.0
LETTA FRACCARO
FAMILY OF BD MBR50203COMP.0
MISTY ADYE
FAMILY OF BD MBR32912COMP.0
ALEX SEIBERT
FAMILY OF OFFICER75814COMP.0
VECTREN ENERGY DELIVERY
COMMON BOARD MEMBER5110974GAS/ELECTRIC UTILITY0
OLD NATIONAL BANK
COMMON BOARD MEMBER1830562LEASES0
EVANSVILLE RADIOLOGY PC
COMMON BOARD MEMBER790733MGMT. SRVS.0
SOUTH CENTRAL COMMUNICATIONS
COMMON BOARD MEMBER128887ADVERTISING PROVIDER0

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
ExplanationSCH L, PART IV, ABBREVIATION: BD MBR = BOARD MEMBERCOMP. = REPORTABLE COMPENSATIONSRVS. = SERVICESExplanation

Schedule M IRS990ScheduleM

Cars And Other Vehicles CarsAndOtherVehicles

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions2NumberOfContributions
Noncash Contribs Rptd F99047928NoncashContribsRptdF990
Method Of Determining RevenuesCOSTMethodOfDeterminingRevenues

Real Estate Commercial RealEstateCommercial

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990290000NoncashContribsRptdF990
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenues

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
DescriptionGIFT CERTIFICATESDescription
Number Of Contributions100NumberOfContributions
Noncash Contribs Rptd F99032471NoncashContribsRptdF990
Method Of Determining RevenuesCOSTMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts1ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierTHIRD PARTY USE:Identifier
Return ReferencePART I, LINE 32B:ReturnReference
ExplanationSCHEDULE M - SUPPLEMENTAL INFORMATION THE NUMBER OF CONTRIBUTIONS REPORTED IN COLUMN B ON SCHEDULE M IS THE ACTUAL NUMBER OF ITEMS RECEIVED FROM EACH CONTRIBUTOR.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (15 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSION:FORM 990, PART III, LINE 1DEACONESS HOSPITAL PROVIDES QUALITY HEALTHCARE SERVICES WITH A COMPASSIONATE AND CARING SPIRIT TO PERSONS, FAMILIES AND COMMUNITIES OF THE TRI-STATE. AT DEACONESS HOSPITAL, OUR VALUES ARE BASED ON OUR COMMITMENT TO QUALITY. WE DEFINE QUALITY AS THE CONTINUOUS IMPROVEMENT OF SERVICES TO MEET THE NEEDS AND EXCEED THE EXPECTATIONS OF THE CUSTOMERS WE SERVE. OUR VALUES ARE QUALITY IN EVERYTHING WE DO, RESPECT FOR ALL PEOPLE, EFFICIENCY AND EFFECTIVENESS IN THE USE OF RESOURCES, INNOVATION TOWARD CONTINUOUS SYSTEMS IMPROVEMENT, PARTNERSHIP WITH THOSE WE SERVE AND WITH SUPPLIERS, EDUCATION FOR CONTINUOUS GROWTH AND KNOWLEDGE AND PRIDE IN WORKMANSHIP. TO ACCOMPLISH ITS MISSION, DEACONESS HOSPITAL IS COMMITTED TO IMPROVING THE QUALITY OF LIFE FOR THE PEOPLE OF THE TRI-STATE BY DEMONSTRATING EXCELLENCE IN HEALTHCARE SERVICES, PROVIDING ACCESS TO HEALTHCARE, PROVIDING CHARITY CARE TO THOSE IN NEED,PROMOTING HEALTHY LIFESTYLES, OFFERING SPIRITUAL AND PSYCHOLOGICAL SUPPORT, SUPPORTING HEALTH RELATED EDUCATION, AND ADVANCING HEALTH KNOWLEDGE THROUGH RESEARCH.
PROGRAM SERVICES ACCOMPLISHMENT 1: PATIENT SERVICE REVENUE.FORM 990, PART III, LINE 4ADEACONESS HOSPITAL IS A MAJOR REFERRAL CENTER FOR A 25 COUNTY TRI-STATE AREA IN SOUTHWESTERN INDIANA, WESTERN KENTUCKY AND SOUTHEASTERN ILLINOIS. THE HOSPITAL AND ITS FACILITIES ARE LOCATED ON FOUR CAMPUSES WHICH INCLUDE THE MAIN 28-ACRE CAMPUS ON THE NEAR NORTH SIDE OF EVANSVILLE IN VANDERBURGH COUNTY; THE 63-ACRE GATEWAY CAMPUS LOCATED IN WARRICK COUNTY ON THE EASTERN BORDER OF VANDERBURGH COUNTY; AND TWO OTHER EASTSIDE EVANSVILLE LOCATIONS FOR PSYCHIATRIC BEHAVIORAL SERVICES AND REHABILITATION SERVICES. THE HOSPITAL OPERATES A MAIN CAMPUS WITH A TOTAL OF 271 BEDS CONSISTING OF 38 INTENSIVE CARE BEDS, 16 CARDIAC INTENSIVE CARE BEDS, 45 CARDIAC BEDS, 23 ONCOLOGY/ PULMONOLOGY BEDS, 61 ORTHOPAEDIC/ NEUROLOGICAL BEDS, 83 MEDICAL/ SURGICAL BEDS AND 5 HOSPICE BEDS. IN ADDITION, THE HOSPITAL PROVIDES A FULL-ARRAY OF COMPREHENSIVE OUTPATIENT AND AMBULATORY SERVICES ON ITS MAIN CAMPUS AND OTHER SPECIFIC SERVICES AT MULTIPLE SITES WITHIN ITS PRIMARY AND SECONDARY SERVICE AREAS. THE HOSPITAL OPERATES THE 158 BED DEACONESS GATEWAY HOSPITAL WHICH WAS OPENED IN JANUARY 2006, ON THE GATEWAY CAMPUS CONSISTING OF 13 ADULT INTENSIVE CARE BEDS, 17 PEDIATRIC AND PEDIATRIC INTENSIVE CARE BEDS, 16 NEUROSURGICAL BEDS, 32 ORTHOPAEDIC BEDS, 16 NEURO INTENSIVE CARE BEDS, 32 SURGICAL ONCOLOGY BEDS AND 32 GENERAL MED/ TELEMETRY BEDS. THE HOSPITAL PROVIDES A FULL ARRAY OF COMPREHENSIVE OUTPATIENT AND AMBULATORY SERVICE ON THE GATEWAY CAMPUS. THE HOSPITAL OWNS AND OPERATES DEACONESS CROSS POINTE, A FREE-STANDING, 60 BED INPATIENT PSYCHIATRIC HOSPITAL LOCATED APPROXIMATELY 7 MILES EAST OF THE MAIN CAMPUS IN EVANSVILLE.
PROGRAM SERVICES ACCOMPLISHMENT 2: CHARITY CARE/ SUBSIDIZED CARE.FORM 990, PART III, LINE 4BDEACONESS HOSPITAL MAKES A DISTINCTION BETWEEN CHARITY CARE AND BAD DEBT. IN DETERMINING AN INDIVIDUAL OR FAMILY'S ABILITY TO PAY, DEACONESS HOSPITAL EVALUATES WHETHER OR NOT THE RESPONSIBLE PARTY HAS SUFFICIENT RESOURCES AVAILABLE FOR PAYMENT. IF AN INDIVIDUAL IS DETERMINED TO NOT HAVE SUFFICIENT RESOURCES TO PAY, THEY ARE CONSIDERED ELIGIBLE FOR CHARITY CARE AND WILL NOT BE PROCESSED THROUGH EITHER INTERNAL OR EXTERNAL COLLECTIONS. ACCOUNTS OF CHARITY CARE PATIENTS WHO ARE UNABLE TO PAY DO NOT RESULT IN BAD DEBT AND ARE NOT COLLECTED UPON. DEACONESS HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS BELOW COST. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. TO THE EXTENT OF REIMBURSEMENT IS BELOW COST, DEACONESS HOSPITAL ABSORBS THESE COSTS IN MEETING ITS MISSION TO THE COMMUNITY. IN SUPPORT OF ITS MISSION, DEACONESS HOSPITAL PROVIDED $22.1 MILLION OF CHARITY CARE AND $15.7 MILLION OF SUBSIDIZED SERVICES TO THE MEDICAID PROGRAM, AND $60.5 MILLION OF SUBSIDIZED SERVICES TO THE MEDICARE PROGRAM.
PROGRAM SERVICE STATEMENTFORM 990, PART III, LINE 4CPROGRAM SERVICES ACCOMPLISHMENT 3: GRADUATE MEDICAL EDUCATION, MEDICAL EDUCATION & COMMUNITY BENEFITS. DEACONESS HOSPITAL PLAYS AN ACTIVE ROLE IN MEDICAL EDUCATION, OPERATING A THREE YEAR FAMILY MEDICINE RESIDENCY PROGRAM AND A POST-GRADUATE PHARMACY RESIDENCY PROGRAM. DEACONESS HOSPITAL ALSO PROVIDES CONTINUING MEDICAL EDUCATION PROGRAMS FOR ATTENDING PHYSICIANS, OTHER HEALTH PROFESSIONALS, OTHER ALLIED HEALTH PROGRAMS, COMMUNITY HEALTH PROGRAMS AND A CHAPLAIN RESIDENCY PROGRAM. IN ADDITION TO EDUCATIONAL SERVICES, DEACONESS HOSPITAL PROVIDED $6.4 MILLION IN COMMUNITY BENEFIT ACTIVITIES (ALL ON A COST BASIS), SERVING A MINIMUM OF 768,486 PEOPLE WITHIN THE TRI-STATE AREA.
ALL OTHER ACCOMPLISHMENTSFORM 990, PART III, LINE 4DOTHER PROGRAM SERVICE REVENUE CONSISTS OF DEACONESS HOSPITAL'S INCOME FROM THE INVESTMENT IN JOINT VENTURES. OTHER PROGRAM SERVICE EXPENSES CONSISTED OF COMMUNITY BENEFIT GRANTS/ASSISTANCE.
FORM 990, PART VI, SECTION A, LINE 6CLASS OF MEMBERS OR STOCKHOLDERS: DEACONESS HEALTH SYSTEM, INC. IS THE SOLE CORPORATE MEMBER OF DEACONESS HOSPITAL, INC.
FORM 990, PART VI, SECTION A, LINE 7AELECTION OF GOVERNING BODY: THE BOARD OF DIRECTORS MAY ELECT ONE OR MORE NON-MEDICAL STAFF MEMBERS OF THE GOVERNING BODY THROUGH AN APPROVED ELECTION AND APPROVAL PROCESS. THE ELECTION AND APPROVAL PROCESS FOR NON-MEDICAL STAFF MEMBERS BEGINS WITH A RECOMMENDATION BY THE GOVERNANCE COMMITTEE FOR MEMBERSHIP TO THE BOARD OF DIRECTORS. THAT RECOMMENDATION IS THEN REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. DEPENDING ON THE DECISION REACHED BY THE BOARD OF DIRECTORS, MEMBERSHIP MAY OR MAY NOT BE GRANTED TO THAT INDIVIDUAL. MEDICAL STAFF EXECUTIVE COUNCIL LEADERSHIP ARE APPOINTED TO BOARD OF DIRECTOR MEMBERSHIP THROUGH THEIR POSITION AS ELECTED MEDICAL STAFF LEADERS. THROUGH THE ELECTION PROCESS OF THE MEDICAL STAFF EXECUTIVE COUNCIL, THEIR APPOINTMENT IS CONFIRMED AND APPROVED.
FORM 990, PART VI, SECTION B, LINE 11FORM 990 REVIEW PROCESS: THE PROCESS THAT DEACONESS HOSPITAL UTILIZES TO PRESENT THE FORM 990 TO ITS GOVERNING BODY PRIOR TO FILING IS TO PRESENT THE FORM 990 TO THE CFO AND CEO OF THE ORGANIZATION FOR REVIEW. AFTER THIS REVIEW IS PERFORMED AND ALL QUESTIONS ARE ANSWERED, THE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS AT THE BOARD MEETING PRIOR TO THE FILING DATE OF THE FORM 990. ANY ADDITIONAL QUESTIONS ARE ANSWERED AND THE FINAL FILING IS THEN COMPLETED.
FORM 990, PART VI, SECTION B, LINE 12CCOMPLIANCE WITH CONFLICT OF INTEREST POLICY: CONFLICT OF INTEREST REVIEW AND COMPLIANCE ACTIVITIES ARE CONDUCTED THROUGHOUT THE YEAR UNDER THE DIRECTION OF DEACONESS HOSPITAL'S CORPORATE COMPLIANCE OFFICER. UPON APPOINTMENT AND, ANNUALLY, THEREAFTER, OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES, ALSO KNOWN AS INTERESTED PERSONS, ARE REQUIRED TO COMPLETE "THE CONFLICTS OF INTEREST QUESTIONNAIRE" AND/OR "THE DISCLOSURE QUESTIONNAIRE". THESE DOCUMENTS SERVE TO ENSURE INTERESTED PERSONS OR COMMITTEE MEMBERS WITH BOARD DELEGATED POWERS HAVE AN APPROPRIATE AND TIMELY MANNER IN WHICH TO DISCLOSE ANY POTENTIAL CONFLICTS. CONFLICTS ARE CONSIDERED WITH RESPECT TO OUTSIDE INTEREST, INVESTMENTS, OUTSIDE ACTIVITIES, AND BUSINESS INTERESTS AMONG THE INTERESTED PERSONS AS WELL AS THEIR FAMILY MEMBERS. ON A PERIODIC BASIS, REVIEWS OCCUR TO ENSURE DEACONESS HOSPITAL OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSE. SUBJECTS THAT ARE REVIEWED ON A PERIODIC BASIS INCLUDE COMPENSATION, PHYSICIAN RELATIONSHIPS, PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION FOR TOP OFFICIALS AND OTHER OFFICERS: DEACONESS HOSPITAL UTILIZES A COMPENSATION COMMITTEE TO APPROVE EXECUTIVE, DIRECTOR AND PHYSICIAN COMPENSATION AS WELL AS EXECUTIVE AND PHYSICIAN BENEFITS PROGRAMS. THE COMPENSATION COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS AND MUST MEET THE INDEPENDENCE REQUIREMENTS OF THE SEC. THE COMMITTEE HAS THE POWER AND AUTHORITY TO: 1. ANNUALLY REVIEW AND APPROVE AND RECOMMEND TO THE BOARD OF DIRECTORS FOR ITS FINAL APPROVAL FOR THE CEO AND EACH OTHER EXECUTIVE OFFICER OF THE SYSTEM ALL ELEMENTS OF EXECUTIVE COMPENSATION. 2. MONITOR BROADLY THE STRUCTURE, PHILOSOPHY OR COMPETITIVENESS OF THE SYSTEM'S GENERAL HIRING OR COMPENSATION PRACTICES. 3. OVERSEE THE ESTABLISHMENT AND ADMINISTRATION OF THE COMPANY'S BROAD-BASED BENEFIT PLANS AND PROGRAMS 4. REVIEW OR APPROVE SIGNIFICANT AMENDMENTS OR CHANGES TO THE PLANS AND PROGRAMS. 5. RETAIN AND TERMINATE ANY COMPENSATION CONSULTANT TO BE USED TO ASSIST IN THE EVALUATION OF DIRECTOR, CEO OR EXECUTIVE OFFICE COMPENSATION 6. SOLE AUTHORITY TO APPROVE THE CONSULTANT'S FEES AND OTHER RETENTION TERMS. 7. OBTAIN ADVICE AND ASSISTANCE FROM INTERNAL OR EXTERNAL LEGAL, ACCOUNTING OR OTHER ADVISORS. 8. APPROVE ALL PHYSICIAN AND PHYSICIAN RELATED CONTRACTS. 9. MAKE REGULAR REPORTS TO THE BOARD.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS DISCLOSURE EXPLANATION: DEACONESS HOSPITAL'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE SECRETARY OF STATE'S WEBSITE. DEACONESS HOSPITAL IS PART OF A CONSOLIDATED FINANCIAL STATEMENT WHICH IS AVAILABLE WITH THE PUBLIC DISCLOSURE COPY OF THE IRS FORM 990. ALSO, AS REQUIRED BY LAW, THE HOSPITAL SUBMITS ITS CONSOLIDATED FINANCIAL STATEMENTS TO THE INDIANA DEPARTMENT OF HEALTH WHICH ARE PUBLISHED ON ITS WEBSITE. GOVERNING DOCUMENTS, ASIDE FROM THE ARTICLES OF INCORPORATION, AND THE CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE FOR PUBLIC INSPECTION.
CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETCFORM 990, PART VIILARRY F PILE - 12035 LONGVIEW LAKE CIRCLE, LAKEWOOD, FL 34211.
OTHER FEESFORM 990, PART IX, LINE 11GPROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 44,186,677. MANAGEMENT AND GENERAL EXPENSES 1,185,051. FUNDRAISING EXPENSES 26,346. TOTAL EXPENSES 45,398,074. PROFESSIONAL FEES- PHYSICIANS: PROGRAM SERVICE EXPENSES 10,689,870. MANAGEMENT AND GENERAL EXPENSES 88,961. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,778,831.
CHANGES IN NET ASSETS OR FUND BALANCES:FORM 990, PART XI, LINE 9:CHANGE IN PENSION LIABILITY 31,884,890. NET UNREALIZED GAIN ON INVESTMENTS 7,547,271. FOUNDATION MONIES GRANTED FROM RESTRICTION -775,678. CAPITAL CONTRIBUTION TO DEACONESS HEALTH SYSTEM -20,613,264. CHANGE IN BENEFICIAL INTERESTS IN TRUSTS 85,722.
OVERSIGHT OF AUDITFORM 990, PART XII, LINE 2CTHE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT; AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1REGIONAL EMERGENCY DEPARTMENTBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1600 MARY STAddressLine1
CityEVANSVILLECity
StateINState
ZIP Code47710ZIPCode
FieldValueIRS element (for citing)
EIN463509500EIN
Primary ActivitiesHEALTHCAREPrimaryActivities
Legal Domicile StateINLegalDomicileState
Total Income-14638TotalIncome
EOY Assets707043EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1DEACONESS HOSPITALBusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
DEACONESS HEALTH SYSTEM INC
600 MARY STREETEVANSVILLEIN47747351532889HEALTHCAREIN501(C)(3)LINE 11A, IN/A0
DEACONESS CLINIC INC
421 CHESNUT STREETEVANSVILLEIN47713263083364HEALTHCAREIN501(C)(3)LINE 30DEACONESS HEALTH SYSTEM

Form990 Schedule R Part III Form990ScheduleRPartIII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
DEACONESS HEALTH PLANS LLC
350 W COLUMBIA SUITE 400EVANSVILLEIN47710383492529PREFERRED PROVIDER NETWORKINDEACONESS HOSPITALRELATED4193651986583000.94130
PROGRESSIVE HEALTH OF IN LLC
150 N ROSENBERGEREVANSVILLEIN47712208480988OUTPATIENTINDEACONESS HOSPITALRELATED21071641012050000.51000
HEART HOSPITAL AT DEACONESS GATEWAY LLC
4007 GATEWAY BLVDNEWBURGHIN47630261766835HOSPITALDEDEACONESS HOSPITALRELATED672819610354199000.51000
TRI-STATE RADIATION ONCOLOGY
1500 ROSECRANS AVENUEMANHATTAN BEACHCA90266263706834OUTPATIENTDEDEACONESS HOSPITALRELATED10189702045142000.51000

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1TRI-STATE MEDICAL MANAGEMENT INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1600 MARY STREETAddressLine1
CityEVANSVILLECity
StateINState
ZIP Code47747ZIPCode
FieldValueIRS element (for citing)
EIN351875888EIN
Primary ActivityPHYSICIAN MANAGEMENTPrimaryActivity
Legal Domicile StateINLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1DEACONESS HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
Percentage Ownership1.00000PercentageOwnership
Controlled Org1ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
DEACONESS HEALTH PLANS LLC
J59888
HEART HOSP AT DEAC GATEWAY LLC
O8742079
HEART HOSP AT DEAC GATEWAY LLC
P1912305
DEACONESS HEALTH PLANS LLC
Q91890
HEART HOSP AT DEAC GATEWAY LLC
Q5456072

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